When working with patients who have had psychotic episodes, the ...

[crobinson2013]

When working with patients who have had psychotic episodes, the nurse knows to monitor for which laboratory analysis for the patient taking clozapine (Clozaril)?
 
  1. WBC
  2. RBC count
  3. Fasting blood sugar
  4. Pro-times and creatine kinase

Question 2

A patient with schizophrenia spectrum disorder presents to the emergency department (ED) with a temperature of 103.5o F. The nurse suspects the patient is experiencing neuroleptic malignant syndrome (NMS), an adverse effect of his antipsychotic medication
 
  For what other symptoms of NMS will nurse assess? Select all that apply.
  1. Grimacing
  2. Diaphoresis
  3. Muscle rigidity
  4. Increased blink rates
  5. Autonomic dysfunction

[k2629]

Answer to Question 1

Answer: 1
Explanation: Clozapine (Clozaril), the first of the second-generation antipsychotics (SGAs), can cause agranulocytosis but is very efficacious. APA (2004) guidelines recommend strict WBC monitoring. The WBC count should be between 2000 and 3000 while using clozapine. RBC count, fasting blood sugars, and pro-times and creatine kinase are not factors that require close monitoring in patients taking clozapine.

Answer to Question 2

Answer: 2, 3, 5
Explanation: Neuroleptic malignant syndrome (NMS) is rare, life-threatening, and sometimes fatal side effect of antipsychotic medications. Symptoms include body temperature that can increase to over 105o F, muscle rigidity, excessive sweating, difficulty swallowing, tremor, incontinence, changes in level of consciousness, inability to speak, autonomic dysfunction, leukocytosis, and elevated creatine kinase. Grimacing and increased blink rates are neurologic soft signs that may occur as symptoms of schizophrenia spectrum disorders and are not indicative of NMS.

[crobinson2013]

TYSM

[Alyson.hiatt@yahoo.com]

Gracias!