Question

The nurse is assigned to a client who, after a medication teaching session with the nurse, began receiving amitriptyline (Elavil) 1 week ago to treat depression. The client now refuses to take the medication, stating that it has caused blurred vision, dry mouth, and constipation, but hasn't improved the mood. Which nursing diagnosis is most appropriate for this client?

1. Noncompliance (treatment regimen) related to treatment resistance
2. Deficient knowledge (treatment regimen) related to inadequate understanding of teaching
3. Anxiety related to unconscious conflict
4. Ineffective coping related to personal vulnerability

Answer 1

The patient's refusal to continue amitriptyline due to side effects and no immediate mood improvement aligns best with the nursing diagnosis 'Noncompliance (treatment regimen) related to treatment resistance.' The nurse's role includes managing side effects and informing about the typical delay in antidepressant effectiveness.

Step-by-step explanation:

The nurse is dealing with a client who refuses to continue with amitriptyline treatment due to experiencing side effects such as blurred vision, dry mouth, and constipation, without perceived improvement in mood. Given that amitriptyline is a tricyclic antidepressant which can lead to side effects and typically requires a period of two to three weeks before mood elevation is noticeable in patients, the most appropriate nursing diagnosis for this situation would be 1. Noncompliance (treatment regimen) related to treatment resistance. This diagnosis is due to the patient's refusal to take the medication as a result of the side effects experienced and the lack of immediate mood improvement. The nurse should address the side effects while educating the patient on the typical onset of beneficial effects of the medication, as antidepressants like amitriptyline require some time before their full therapeutic effects are felt.