A patient receiving haloperidol urgently calls to the nurse and ...

[cmoore54]

A patient receiving haloperidol urgently calls to the nurse and reports that his eyes have rolled upward and he cannot redirect his gaze. The nurse contacts the physician to seek an order for:
 
  a. Fluphenazine (Prolixin)
  b. Citalopram (Celexa)
  c. Benztropine (Cogentin)
  d. Risperidone (Risperdal)

Question 2

A patient whose schizophrenia has been refractory to treatment with other medications has been placed on clozapine (Clozaril). The priority discharge teaching should include:
 
  a. Keep salt intake the same from day to day.
  b. Maintain a strict tyramine-free daily diet.
  c. Report for weekly blood tests for CBC level.
  d. Use sunblocking agents when out of doors.

[nmyers]

Answer to Question 1

ANS: C
The nurse should recognize the patient's problem as dystonia and know the treatment is IM administration of an antiparkinsonian drug, such as benztropine, or an antihistamine, such as diphenhydramine (Benadryl), for which a physician's order is necessary. Fluphenazine (Pro-lixin) would worsen the condition. The remaining options would not be useful.

Answer to Question 2

ANS: C
Clozaril has the potential to cause agranulocytosis; hence the need for weekly blood draws for CBCs for the first 6 months of therapy and every other week after that point. The other options are not relevant to Clozaril therapy. Salt intake refers to lithium therapy, tyramine to MAOI therapy, and sunblocking to phenothiazine therapy.