Clinical context A 45-year-old with Huntington chorea is being evaluated before tetrabenazine is started and titrated; the nurse reviews mood history, current medicines, and the proposed target dose. Which findings require clarification before starting or escalating tetrabenazine for Huntington chorea? Select exactly 3 responses.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Tetrabenazine can increase depression and suicidality and is contraindicated in actively suicidal clients or those with untreated or inadequately treated depression. CYP2D6 genotyping is required before doses above 50 mg/day.
Quick answer Screen suicide risk, depression treatment, and CYP2D6 before high-dose tetrabenazine.
Why this is correct Chorea improvement must be balanced against mood, parkinsonism, sedation, akathisia, and QT-related risks.
Easy analogy or mental picture Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.
Memory hook Drug, urgent cue, protective action, and reassessment endpoint.
NCLEX decision rule Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.
Why the other choices are wrong Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.
References
1DailyMed: Tetrabenazine TabletsDepression and suicidality contraindications plus CYP2D6 dose threshold
Clinical contextA 45-year-old with Huntington chorea is being evaluated before tetrabenazine is started and titrated; the nurse reviews mood history, current medicines, and the proposed target dose.