ABRAMS CH 56

For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically there after?

White blood cell count (WBC) - due to risk of fatal agranulocytosis

Chlorpromazine is contraindicated for a client with what medical diagnosis? Select all that apply

stroke, major depression, cirrhosis

During health education with the nurse, what subject should be the primary focus for a client newly diagnosed with schizophrenia?

the importance of adherence to prescribed treatment

For which client would the nurse question the use of antipsychotic medication therapy?

An 81 year old whose delusions and psychosis are attributable to dementia - many antipsychotics are associated with increased risk of death in older adults who have dementia bbw

When monitoring a client for possible neuroleptic malignant syndrome, the nurse will plan to implement what intervention into client care? Select all that apply

Assess temperature every 8 hours, monitor for signs of respiratory distress, document urinary output into client records every 8 hours

When participating in care planning for a child who has been diagnosed with schizophrenia, the nurse should be aware of what fact?

It is not clear which drugs are the safest and most effective in children with schizophrenia

What client statement reflects an understanding of typical length of antipsychotic medication therapy?

I may always have to take this medication - people with schizophrenia usually need to take antipsychotics for years because there is a high rate of relapse

The nurse monitoring a client prescribed chlorpromazine for adverse reactions should plan on including which interventions into the plan of care? Select all that apply

Monitor white blood cell count (WBC), take and record daily weight, monitor urinary output

The psychiatric nurse is conducting health education addressing the adverse effects of clozapine. What teaching point should the nurse convey to the client?

There's a possibility that this drug might cause you to gain weight and have high blood sugar levels

What goal would be appropriate for a client during the first week of treatment for acute psychosis? Select all that apply

decreasing the client's symptoms and normalizing the patterns of eating and sleeping

A client who began treatment with clozapine 2 weeks ago is now reporting worsening flu like symptoms, including a high fever. the nurse's assessment should be conducted with the goal of identifying signs and symptoms of what possible adverse medication reaction?

agranulocytosis - deficiency of granulocytes (type of white blood cells) in the blood causing increased vulnerability to infection

After administration of haloperidol to an acutely dehydrated client, the nurse should prioritize what nursing assessment?

blood pressure - haloperidol can cause hypotension in clients who are volume depleted or receiving antihypertensive drugs

What behavior would cause the nurse to suspect a client is demonstrating an extrapyramidal effect (EPS) of antipsychotic drug therapy? Select all that apply

inability to stay seated for any length of time (akathisia), repeated involuntary twisting of the arms (dystonia), near constant lip smacking (tar dive dyskinesia)

What is the nursing priority for a client experiencing acute dystonia?

maintaining client safety - dystonia involves uncoordinated bizarre movements of the neck face eyes tongue trunk or extremities

Phenothiazines such as chlorpromazine are occasionally used for clinical indications not associated with psychiatric illness. What indications would be included? Select all that apply

preoperative restlessness and nausea and vomiting