A client with a history of suicidal behavior and schizophrenia ...

[Collmarie]

A client with a history of suicidal behavior and schizophrenia stopped taking clozapine (Clozaril) after four weeks of therapy.
 
  The client is currently experiencing a return of hallucinations. What might the nurse assess when determining the reason the client stopped taking the medication?
  Standard Text: Select all that apply.
  1. Feeling sedated all the time
  2. Significant weight gain
  3. Agitation
  4. Fatigue and headache
  5. Lack of desire to consume alcohol

Question 2

A client prescribed haloperidol (Haldol) is not demonstrating an improvement of psychotic behavior after taking the medication for 5 days. The nurse would anticipate which dose change for the medication?
 
  1. No changes are necessary, as it might take 24 weeks for significant improvement to be noted.
  2. The dose of Haldol might be increased.
  3. The order for Haldol might be discontinued.
  4. Xanax might be added to improve the symptoms of psychotic behavior.

[Pamela.irrgang@yahoo.com]

Answer to Question 1

Correct Answer: 1,2,3,4
Rationale 1: Clients do not like the side effect of being sedated all the time.
Rationale 2: Substantial weight gain has been reported in some clients taking this medication. This is a reason some stop taking the medication.
Rationale 3: Agitation may be an extrapyramidal symptom of treatment with this medication and is an unwanted adverse effect.
Rationale 4: Fatigue and headache are possible side effects of this medication.
Rationale 5: The desire to drink alcohol would be a reason for the client to stop taking this medication.
Global Rationale: Clients do not like the side effect of being sedated all the time. Substantial weight gain has been reported in some clients taking this medication. This is a reason some stop taking the medication. Agitation may be an extrapyramidal symptom of treatment with this medication and is an unwanted adverse effect. Fatigue and headache are possible side effects of this medication. The desire to drink alcohol would be a reason for the client to stop taking this medication.

Answer to Question 2

Correct Answer: 1
Rationale 1: The pharmacotherapy of psychosis is a long-term process, with symptoms resolving gradually. It could take 24 weeks before a significant change in behavior is noted.
Rationale 2: Haldol is a high-potency drug that controls symptoms in small doses. Increasing the dose would cause severe side effects.
Rationale 3: The Haldol has not been taken long enough to warrant discontinuation, and there is no information indicating that it should be discontinued due to side effects.
Rationale 4: The addition of a benzodiazepine would cause added CNS depression.
Global Rationale: The pharmacotherapy of psychosis is a long-term process, with symptoms resolving gradually. It could take 24 weeks before a significant change in behavior is noted. Haldol is a high-potency drug that controls symptoms in small doses. Increasing the dose would cause severe side effects. The Haldol has not been taken long enough to warrant discontinuation, and there is no information indicating that it should be discontinued due to side effects. The addition of a benzodiazepine would cause added CNS depression.

[Collmarie]

Excellent

[helenmarkerine]

TYSM