A male client with a newly diagnosed seizure disorder starts a prescription for clonazepam. One week later, the nurse observes that his speech is slurred and he has an ataxic gait. Which action should the nurse implement?

Explain the need to refrain from alcohol use while taking the drug

Document the client's continued seizure activity.

Advise the client to discontinue the medication immediately.

Report these side effects to the healthcare provider.

Answer and Explanation

The Correct Answer is D

A. Explain the need to refrain from alcohol use while taking the drug: Although avoiding alcohol is very important when taking clonazepam due to increased central nervous system depression, the client’s current symptoms of slurred speech and ataxia are concerning side effects that must be addressed first through immediate clinical intervention rather than just education.

B. Document the client's continued seizure activity: Slurred speech and ataxia are not typical signs of seizure activity; they are more indicative of central nervous system depression or toxicity from clonazepam. Simply documenting the symptoms without further action could delay critical treatment adjustments.

C. Advise the client to discontinue the medication immediately: Abruptly stopping clonazepam can lead to withdrawal seizures and other serious complications. Medication discontinuation should always be managed carefully under the direction of the healthcare provider to prevent additional risks.

D. Report these side effects to the healthcare provider: Slurred speech and an ataxic gait suggest clonazepam toxicity or overdose. Promptly notifying the healthcare provider allows for dosage adjustment or possible medication change, which is essential to prevent worsening central nervous system depression and maintain patient safety.

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Correct Answer is A

Explanation

A. Dry mouth, blurred vision, and constipation: These symptoms are classic anticholinergic side effects associated with many antidepressants, especially tricyclic antidepressants (TCAs). They result from the blockade of muscarinic receptors and are frequently reported by clients receiving these medications.

B. Headache, jaundice, and diarrhea: While headaches can occur with antidepressant use, jaundice is rare and would suggest serious liver toxicity rather than a common side effect. Diarrhea may happen with selective serotonin reuptake inhibitors (SSRIs) but is less typical overall than anticholinergic symptoms.

C. Bradycardia, delirium, and sedation: Some antidepressants can cause sedation, but bradycardia and delirium are not common side effects across the entire antidepressant class. These would be more likely associated with toxicity or drug interactions rather than typical daily use.

D. Insomnia, hypertension, and vomiting: Insomnia can occur with certain antidepressants like SSRIs or SNRIs, but hypertension and vomiting are less consistently seen across all antidepressant classes. These symptoms are not considered the hallmark side effects of antidepressant therapy.

A. Administer an additional dose of naloxone. B. Initiate a second intravenous access site. C. Prepare to initiate cardiopulmonary resuscitation (CPR). D. Determine if results of the drug toxicity screen are available.

Correct Answer is A

Explanation

A. Administer an additional dose of naloxone: Naloxone has a shorter half-life than many opioids, leading to the recurrence of respiratory depression once its effects wear off. When signs of opioid toxicity return, the immediate priority is to administer another dose of naloxone to reverse life-threatening respiratory depression and restore adequate ventilation.

B. Initiate a second intravenous access site: While maintaining IV access is important in emergency care, establishing a second IV line is not the most urgent priority when the client’s breathing is dangerously slow. Immediate reversal of respiratory depression takes precedence.

C. Prepare to initiate cardiopulmonary resuscitation (CPR): CPR is indicated if the client has no pulse or is not breathing. Since the client is still breathing, although minimally, and has a pulse, the immediate action should be reversing the opioid effects with naloxone, not starting CPR.

D. Determine if results of the drug toxicity screen are available: While knowing the substances involved can guide further treatment, waiting for lab results would delay the critical intervention needed to treat the acute respiratory depression at this moment.

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A male client with a newly diagnosed seizure disorder starts a prescription for clonazepam. One week later, the nurse observes that his speech is slurred and he has an ataxic gait. Which action should the nurse implement?

Nursing Test Bank

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Explanation

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