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The nurse continues to care for the client.
Exhibits
The nurse administers the client's scheduled medication. Which of the following adverse effects of the medication should the nurse monitor the client for? Select all that apply.

Sudden muscular contractions

Orthostatic hypotension

Anticholinergic effects

Tremors

Sedation

Increased urination

Answer and Explanation

Correct Answer : A,B,C,D,E

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.

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Correct Answer is D

Explanation

Rationale:

A. A client who has decreased interleukin-6 levels: Interleukin-6 is a pro-inflammatory cytokine that may be elevated in depression, but its decrease is not an indicator for antidepressant use. It’s not routinely used to determine the need for antidepressant therapy in clinical practice.

B. A client who has decreased urine cortisol levels: Depression is more commonly associated with increased cortisol levels due to stress responses. Low cortisol may be seen in conditions like Addison's disease but does not typically guide antidepressant use.

C. A client who has decreased C-reactive protein levels: CRP is a nonspecific inflammatory marker. While elevated CRP has been observed in some individuals with depression, a decreased CRP level would not indicate the need for antidepressant therapy.

D. A client who has decreased serotonin levels: Low serotonin levels are closely linked to depression pathophysiology. Many antidepressants, such as SSRIs, target serotonin levels to relieve depressive symptoms, making this the most relevant indicator for antidepressant therapy.

A. "You are feeling anxious now; why don't you give it some time before making a final decision?" B. "You should talk with your family members before making this decision." C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow." D. "Let me refer you to talk to someone regarding your treatment options."

Correct Answer is D

Explanation

Rationale:

A. "You are feeling anxious now; why don't you give it some time before making a final decision?": This minimizes the client’s current emotional distress and does not address the seriousness of the statement. It may come across as dismissive rather than therapeutic.

B. "You should talk with your family members before making this decision.": Although involving family in major decisions can be helpful, the focus should be on the client's feelings and wishes first.

C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow.": Deferring the conversation may delay support for someone expressing emotional exhaustion and possible suicidal ideation. Prompt intervention is essential in these situations.

D. "Let me refer you to talk to someone regarding your treatment options.": This response acknowledges the client's emotional state while also offering a supportive and appropriate next step. It opens access to counseling or mental health services and helps the client explore options without judgment.

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The nurse continues to care for the client.Exhibits The nurse administers the client's scheduled medication. Which of the following adverse effects of the medication should the nurse monitor the client for? Select all that apply.

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The nurse continues to care for the client.
Exhibits
The nurse administers the client's scheduled medication. Which of the following adverse effects of the medication should the nurse monitor the client for? Select all that apply.