The client with schizophrenia was started on imipramine (Tofranil) for a depressed mood and subsequently started hearing voices again and refuses to take the Tofranil because the client thinks it is poison. The nursing response is based on what information?

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Tricyclic antidepressants like imipramine can trigger overt psychotic symptoms in someone with schizophrenia, and this may be the reason for the client's worsening symptoms after starting the medication. The nursing response should involve assessing the client's current symptoms and working with the treatment team to adjust the medication regimen as needed. It may be necessary to discontinue the imipramine and consider a different medication that is better tolerated by the client.

The Client with Schizophrenia Was Started on Imipramine (Tofranil) for a Depressed