A nurse on a postpartum unit is caring for a client. For each finding, click to specify if the finding is consistent with uterine atony or infection.

Exhibits

Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row. Note: Each column must have at least 1 response option selected

Rationale:

A. Sudden muscular contractions: Antipsychotics like haloperidol and chlorpromazine can cause extrapyramidal symptoms (EPS), including acute dystonia, which manifests as sudden, involuntary muscle contractions typically affecting the face, neck, or back.

B. Orthostatic hypotension: Chlorpromazine, a low-potency typical antipsychotic, often causes orthostatic hypotension due to its alpha-adrenergic blockade, increasing fall risk, especially in older adults or those new to therapy.

C. Anticholinergic effects: These include dry mouth, blurred vision, constipation, and urinary retention. Chlorpromazine is particularly known for its anticholinergic side effects due to its action on muscarinic receptors.

D. Tremors: Tremors are part of parkinsonian side effects, another form of EPS commonly caused by haloperidol. They result from dopamine blockade in the nigrostriatal pathway.

E. Sedation: Both haloperidol and chlorpromazine can cause sedation. Chlorpromazine is especially sedating due to its histamine (H1) receptor blockade, which depresses the CNS.

F. Increased urination: Not typically associated with these medications. In fact, anticholinergic effects from chlorpromazine more often lead to urinary retention, not increased urination.

Rationale:

A. Administer a dose of atomoxetine to decrease anxiety: Atomoxetine is a non-stimulant medication used primarily for ADHD, not for acute anxiety or panic attacks. It is not effective for treating panic symptoms and is not appropriate in this situation.

B. Sit with the client to provide a sense of security: Remaining with the client during a panic attack helps reduce fear, provides emotional support, and ensures safety. Calm presence and reassurance are essential to help the client regain a sense of control.

C. Encourage the client to watch television: Watching television requires attention and focus, which may be impaired during a panic attack. This suggestion does not address the immediate need for safety, calm, and emotional support.

D. Teach the client how to meditate: Teaching new coping techniques during a panic attack may be ineffective, as the client is overwhelmed and unable to concentrate. Such strategies are better introduced when the client is calm and receptive.