Psychotherapeutic Meds PrepU
For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically thereafter? partial thromboplastin time (PTT) white blood cell (WBC) count red blood cell (RBC) count blood urea nitrogen (BUN)
Correct response: white blood cell (WBC) count Explanation: It is essential to monitor the WBC counts of the client taking clozapine due to the risk of fatal agranulocytosis. Coagulation tests, RBC counts, and measurement of BUN are not indicated.
A black, male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the health care provider's (HCP's) office with signs of tardive dyskinesia, and his HCP modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen? "The signs of tardive dyskinesia will diminish over time." "Black clients always experience tardive dyskinesia with antipsychotics." "When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients." "The olanzapine does not produce side effects in black males."
Correct response: "When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients." Explanation: Black clients tend to respond more rapidly; experience a higher incidence of adverse effects, including tardive dyskinesia; and metabolize antipsychotic drugs more slowly than white clients. When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients.
The nurse is providing education to a client who has been prescribed clozapine. The nurse should emphasize the importance of what monitoring routine during teaching? Weekly liver enzymes Daily international normalized ratio (INR) Monthly creatinine levels Regular complete blood counts
Correct response: Regular complete blood counts Explanation: Clozapine is associated with life-threatening decrease in white blood cells (agranulocytosis). It is essential to monitor the complete blood count due to this risk. Weekly liver enzymes, monthly creatinine levels (kidney function), and INR monitoring (blood clotting function) are not recommended with clozapine therapy.
A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine. The client has been taking the medication for more than 40 years. What adverse effect will the client most likely experience? Hypertension Tardive dyskinesia Central nervous system agitation Urinary frequency
Correct response: Tardive dyskinesia Explanation: A client who has taken chlorpromazine on a long-term basis will be at risk for late extrapyramidal effects, such as tardive dyskinesia. Hypertension is not an adverse effect of chlorpromazine, but hypotension is an adverse effect. Central nervous system agitation is not an adverse effect of chlorpromazine, but central nervous system depression is an adverse effect. Urinary frequency is not an adverse effect of chlorpromazine, but urinary retention is an adverse effect.
The nurse admits a client newly diagnosed with schizophrenia to the inpatient mental health unit. What is the priority reason why the nurse includes the family when collecting the nursing history? The client may not be able to provide a sufficient history. The client may have a reduced level of consciousness. The family will feel empowered by being included in the process. The client will be less anxious if the family listens while answering questions.
Correct response: The client may not be able to provide a sufficient history. Explanation: Schizophrenia, the most common psychosis, is characterized by delusions, hallucinations, and inappropriate responses to stimuli. As a result, the client may be unable to provide a coherent history and may be unaware of their behaviors considered dysfunctional. There is no reason to suspect the client's level of consciousness is impaired, and reducing anxiety is not the priority rationale for including family. While family is included in treatment, the goal is to treat the client and not make the family feel better.
Which test should be scheduled every week for a patient taking clozapine? Serum lithium WBC count Blood glucose pH level
Correct response: WBC count Explanation: Use of the drug clozapine has been associated with severe agranulocytosis, (i.e., decreased white blood cells), so weekly WBC count tests are scheduled. Serum lithium tests are taken for patients who have been administered lithium, not clozapine. There is no need to take blood glucose or pH level tests.
After administration of haloperidol to an acutely dehydrated client, the nurse should prioritize what nursing assessment? visual acuity blood pressure core body temperature deep tendon reflexes
Correct response: blood pressure Explanation: Haloperidol can cause hypotension in clients who are volume depleted or receiving antihypertensive drugs. The client is unlikely to develop hyperthermia, diminished reflexes, or visual dysfunctions.
Antipsychotic drugs are contraindicated in clients with: liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease. kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain. nausea, severe hypotension, or intractable hiccups. peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure.
Correct response: liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease. Explanation: Because of their wide-ranging adverse effects, antipsychotic drugs may cause or aggravate a number of conditions. They are contraindicated in clients with liver damage, coronary artery disease, cerebrovascular disease, parkinsonism, bone marrow depression, severe hypotension or hypertension, coma, or severely depressed states. They should be used cautiously in people with seizure disorders, diabetes mellitus, glaucoma, prostatic hypertrophy, peptic ulcer disease, and chronic respiratory disorders.