A client with psychosis who is receiving an antipsychotic medication is continually rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

Choice A reason: Priming the inhaler with 7 pumps is an incorrect action, as it wastes the medication and reduces the number of doses available. The nurse should teach the client that ipratropium inhaler only needs to be primed once when it is first used, or if it has not been used for more than 3 days. To prime the inhaler, the client should spray it into the air away from the face until a fine mist appears.

Choice B reason: Rinsing the mouth after each use is a correct action, as it prevents dry mouth and irritation caused by the medication. Ipratropium is an anticholinergic drug that blocks the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and mucus. The nurse should teach the client to rinse the mouth with water or mouthwash after using the inhaler, and to drink plenty of fluids to stay hydrated.

Choice C reason: Storing the medication at room temperature is a correct action, as it preserves the quality and effectiveness of the medication. The nurse should teach the client to store the ipratropium inhaler at room temperature, away from heat, moisture, and direct sunlight. The nurse should also instruct the client to check the expiration date and the dose counter of the inhaler, and to replace it when it is empty or expired.

Choice D reason: Attaching spacer device to the inhaler is a correct action, as it improves the delivery and absorption of the medication. A spacer is a device that attaches to the mouthpiece of the inhaler and creates a chamber that holds the medication until the client inhales it. The nurse should teach the client to use a spacer with the ipratropium inhaler, as it can reduce the risk of side effects, such as coughing, throat irritation, and hoarseness. The nurse should also teach the client how to clean and maintain the spacer device.

Choice A reason: Providing a heating pad to the client may provide some temporary relief, but it does not address the underlying cause of the neck discomfort, which is likely due to extrapyramidal side effects (EPS) of the antipsychotic medication.

Choice B reason: Obtaining a prescription for physical therapy services may be beneficial for the client's overall health and well-being, but it is not the best intervention for the acute problem of neck discomfort. Physical therapy may also require a referral and a waiting period, which would delay the relief for the client.

Choice C reason: Giving a PRN prescription for benztropine is the best intervention for the nurse to implement, as benztropine is an anticholinergic medication that can counteract the EPS of the antipsychotic medication. Benztropine can reduce the muscle stiffness and spasms that cause the neck discomfort.

Choice D reason: Obtaining an extra pillow for the client to use at night may help the client sleep better, but it does not address the neck discomfort during the day. It also does not treat the EPS of the antipsychotic medication, which may worsen over time.