The nurse is caring for a client who has been prescribed chlorpromazine. The nurse correctly identifies which of the client's body system as being associated with the majority of the medications adverse effects?

A. The client's bowel sounds are reduced: Decreased bowel sounds may indicate slowed intestinal motility, which is not a desired effect of psyllium. Normal or active bowel sounds would be more consistent with the therapeutic goal of increased peristalsis and bowel regularity.

B. The client remains free of diarrhea: Psyllium is a bulk-forming laxative that normalizes stool consistency. While avoiding diarrhea is beneficial, the absence of diarrhea alone does not confirm the medication is effectively treating constipation or achieving its full therapeutic effect.

C. The client has two to three bowel movements daily: While this frequency may be acceptable for some clients, it is not the primary therapeutic target of psyllium. Psyllium works by absorbing water and increasing stool bulk, and frequency can vary depending on individual bowel patterns.

D. The bulk of the client's stools is increased: Psyllium functions by forming a gel-like mass when mixed with water, which increases stool bulk and triggers peristalsis. This outcome directly reflects the expected therapeutic effect and is the best indicator that the medication is working properly.

A. renal: Chlorpromazine is metabolized primarily in the liver and excreted via the kidneys, but it does not commonly cause renal toxicity. The renal system is not the main site of adverse effects for this medication.

B. central nervous system (CNS): Chlorpromazine is an antipsychotic that works by blocking dopamine receptors in the brain. The majority of its adverse effects are CNS-related, including sedation, extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome.

C. cardiovascular: Although chlorpromazine can cause hypotension and prolong the QT interval, cardiovascular effects are less common than CNS effects. They are important to monitor but not the predominant source of adverse reactions.

D. integumentary: Skin-related effects such as photosensitivity or allergic reactions may occur but are relatively rare. The integumentary system is not the primary body system affected by chlorpromazine’s mechanism or side effect profile.