A client is prescribed venlafaxine (Effexor) for depression, but the client refuses due to headaches. What should the practical nurse do?

A client is prescribed venlafaxine (Effexor) for depression, but the client refuses due to headaches. What should the practical nurse do?

• A. Do not give the medication because the client has withdrawn her consent.
• B. Tell the charge nurse the situation to see if she can convince the client to take the medication.
• C. Administer the medication because the client has been diagnosed with depression.
• D. Insist that the client take the medication but tell her she will give her Tylenol for the headache.

Answer: (A)

Respecting the client’s autonomy and ability to consent is the central idea here. If a competent adult clearly declines a prescribed medication, you do not administer it. In this case, the client has refused venlafaxine because of headaches, so the appropriate action is to honor that decision rather than pressure or override it. Begin by acknowledging the client’s concern about headaches and invite discussion to better understand the refusal. Provide clear information about the benefits and risks of the medication, and explore alternatives—such as adjusting the dose, trying a different antidepressant, or adding nonpharmacologic strategies—without coercion. Document the refusal and the discussion thoroughly, and inform the prescriber to determine the next steps. If the client’s decision-making capacity were in question, you would escalate to determine capacity, but with a willing, competent adult, you support the choice and continue to monitor the depression and overall care.

Respecting the client’s autonomy and ability to consent is the central idea here. If a competent adult clearly declines a prescribed medication, you do not administer it. In this case, the client has refused venlafaxine because of headaches, so the appropriate action is to honor that decision rather than pressure or override it.

Begin by acknowledging the client’s concern about headaches and invite discussion to better understand the refusal. Provide clear information about the benefits and risks of the medication, and explore alternatives—such as adjusting the dose, trying a different antidepressant, or adding nonpharmacologic strategies—without coercion. Document the refusal and the discussion thoroughly, and inform the prescriber to determine the next steps. If the client’s decision-making capacity were in question, you would escalate to determine capacity, but with a willing, competent adult, you support the choice and continue to monitor the depression and overall care.