A nurse is reinforcing teaching with a client who started taking haloperidol decanoate 125 mg IM 1 month ago. Which of the following statements by the client should the nurse address?
"I haven't had a drink of alcohol since I started taking these injections."
"I spend several hours a day outside gardening when it's sunny."
"I check my blood pressure once a week.
"I chew sugar-free gum several times daily."
The Correct Answer is B
A. This statement indicates that the client has abstained from alcohol while on haloperidol decanoate. This is a positive statement and shows compliance with recommendations, as alcohol can interact with medications and affect their effectiveness or cause adverse reactions. There is no immediate concern with this statement.
B. Haloperidol can increase sensitivity to sunlight (photosensitivity). Spending several hours outside gardening in the sun could potentially increase the risk of sunburn or other skin reactions due to photosensitivity. The nurse should address this statement by educating the client about the need to use sunscreen, wear protective clothing, and avoid prolonged sun exposure, especially during peak sunlight hours.
C. Regular monitoring of blood pressure is generally recommended for clients taking haloperidol, as it can occasionally cause hypotension (low blood pressure) as a side effect. Checking blood pressure once a week is a reasonable frequency, but the nurse should ensure that the client understands the signs and symptoms of hypotension and knows when to seek medical attention if blood pressure readings are abnormal.
D. Chewing sugar-free gum is generally not contraindicated while taking haloperidol. However, if the gum contains caffeine or other stimulants, it could potentially exacerbate certain side effects of the medication, such as tremors or restlessness. The nurse should inquire further about the type of gum being used and educate the client about potential interactions or side effects.
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Related Questions
Correct Answer is A
Explanation
A. This technique involves allowing the client to remove themselves from the situation causing agitation temporarily. It is a de-escalation technique where the client can regain composure and reduce agitation by being alone or in a quieter environment. The nurse ensures the environment is safe and monitors the client during this time.
B. Restraint involves physically restricting the client's movement to prevent harm to themselves or others when they are in a state of extreme agitation and are at risk of causing harm. It is used as a last resort and typically requires a healthcare provider's order due to the potential risks and ethical considerations.
C. Diversion involves redirecting the client's attention away from the source of agitation to something else, such as a calming activity or a change of topic. It can help shift the client's focus and reduce escalating emotions.
D. Also known as a therapeutic restraint hold, this technique is used to safely manage a client who is agitated and may become physically aggressive. It involves trained staff using specific holds to restrain the client in a way that prevents harm while allowing for therapeutic communication.
Correct Answer is A
Explanation
A. Veracity involves providing accurate and truthful information to the client. By reinforcing information about potential adverse effects of a medication, the nurse ensures that the client is fully informed. This aligns with the principle of veracity because it involves transparency and honesty in discussing the potential risks associated with treatment.
B. Respecting the client's autonomy and right to make decisions about their treatment plan relates more to the ethical principle of autonomy rather than veracity. While respecting autonomy is essential, it doesn't directly address truthfulness or honesty in communication.
C. Encouraging a client to participate in a daily exercise program supports their physical well-being and can be beneficial for their recovery. However, it doesn't specifically relate to the ethical principle of veracity, which focuses on truthful communication.
D. Confidentiality is another ethical principle that pertains to protecting the client's privacy and maintaining confidentiality of their health information. While important, it doesn't directly relate to veracity, which is about honesty and truthfulness in communication with the client.
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