A nurse is caring for a client in a clinic. Exhibits For each body system below, click to specify the adverse effect that the nurse should include in the teaching. Choose the most likely response for the dropdown(s) in the table below by choosing from the lists of options. Body System Common Adverse Effects Head, eyes, ears, nose, and throat (HEENT) dropdown Cardiovascular dropdown Genitourinary dropdown Gastrointestinal dropdown

Rationale for Correct Choices: Blurred vision: Amitriptyline causes anticholinergic effects such as blurred vision by impairing lens accommodation. This effect is common in the early stages of treatment and may improve over time. Orthostatic hypotension: Amitriptyline reduces peripheral vascular resistance, which can cause blood pressure to drop when a client changes position. This increases the risk for falls, especially in older adults. Urinary retention: Anticholinergic effects from amitriptyline reduce bladder contractility, leading to urinary retention. This is especially concerning in clients with prostate enlargement or existing urinary difficulties. Constipation: Decreased gastrointestinal motility caused by anticholinergic activity makes constipation a common and expected side effect. Clients should be advised to increase fiber and fluid intake. Rationale for Incorrect Choices: HEENT: Hearing loss is not associated with tricyclic antidepressants like amitriptyline, which do not affect the auditory system. Photophobia typically results from conditions like migraines or uveitis, not from tricyclic antidepressant use. Cardiovascular: Hypertension is not a known side effect of amitriptyline. The medication more commonly lowers blood pressure through vasodilation. Bradycardia is not expected with amitriptyline. In fact, the drug may cause tachycardia due to its effect on cardiac conduction. Genitourinary: Urinary incontinence is not typical with amitriptyline. The drug’s anticholinergic properties reduce bladder contractility, increasing the risk of retention instead. Increased libido is not a side effect of tricyclic antidepressants. These medications are more likely to decrease libido and may contribute to sexual dysfunction. Gastrointestinal: Dry mouth is a common anticholinergic effect but does not directly impact gastrointestinal motility, making it a less appropriate answer in this system category. Diarrhea is not expected with anticholinergic drugs like amitriptyline, which slow bowel movements and increase the risk for constipation.