A nurse is caring for a client who has a ventricular dysrhythmia and a new prescription for amiodarone. Which of the following interventions should the nurse include in the client's plan of care?

Choice A rationale Amiodarone is known to cause various adverse effects, but ototoxicity leading to hearing impairment is not a commonly reported or significant side effect. The primary concerns with amiodarone involve pulmonary, thyroid, hepatic, and ocular toxicities. Therefore, routine hearing screenings are not a standard intervention in the care plan for clients on amiodarone. Choice B rationale An increase in appetite is not a recognized or common adverse effect associated with amiodarone. Amiodarone can cause gastrointestinal side effects such as nausea, vomiting, and anorexia, but an increased appetite is not typically observed. Monitoring for such a symptom would not be a priority in the client's plan of care. Choice C rationale Amiodarone is extensively metabolized by the liver and is known to cause hepatotoxicity, ranging from asymptomatic transaminase elevation to severe hepatitis and cirrhosis. Therefore, periodic monitoring of liver enzyme levels (e.g., AST, ALT, alkaline phosphatase) is crucial to detect early signs of liver injury and adjust treatment if necessary. Normal AST levels are typically 10-40 U/L, and ALT levels are 7-56 U/L. Choice D rationale While some medications can cause psychiatric disturbances, manic behavior is not a commonly reported or characteristic adverse effect of amiodarone. The central nervous system effects of amiodarone are more likely to include peripheral neuropathy, ataxia, and tremors. Monitoring for manic behavior is not a standard intervention for clients on amiodarone therapy.