A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months. The client has a temperature of 39.5* C (103.4° F), blood pressure of 150/110 mm Hg, and muscle rigidity. Which of the following complications should the nurse suspect?
Akathisia
Neuroleptic malignant syndrome
Tardive dyskinesia
Agranulocytosis
The Correct Answer is B
A. Akathisia: Akathisia is characterized by restlessness and an inability to sit still. While it can be a side effect of antipsychotic medications like haloperidol, it does not present with fever, hypertension, and muscle rigidity, as described in the scenario.
B. Neuroleptic malignant syndrome (NMS): NMS is a potentially life-threatening condition associated with antipsychotic medications like haloperidol. It is characterized by hyperthermia, autonomic dysfunction (e.g., hypertension), altered mental status, and severe muscle rigidity. The client's symptoms of fever, elevated blood pressure, and muscle rigidity are consistent with NMS.
C. Tardive dyskinesia: Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face, tongue, and other body parts. It is a long-term side effect of antipsychotic medications and typically develops after prolonged use, unlike the acute onset seen in the scenario.
D. Agranulocytosis: Agranulocytosis is a rare but serious side effect of antipsychotic medications, characterized by a severe reduction in white blood cell count, leading to an increased risk of infection. The symptoms described in the scenario are not consistent with agranulocytosis.
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Correct Answer is D
Explanation
A. Bleeding: While haloperidol can cause side effects such as orthostatic hypotension and sedation, it is not typically associated with bleeding as a common adverse effect.
B. Pancreatitis: Pancreatitis is not a common adverse effect of haloperidol. However, it can cause gastrointestinal side effects such as constipation, nausea, and vomiting.
C. Cataracts: Haloperidol is not known to cause cataracts. However, long-term use of antipsychotic medications, including haloperidol, may increase the risk of developing metabolic side effects such as weight gain, dyslipidemia, and hyperglycemia, which can contribute to conditions like diabetes and potentially increase the risk of cataracts.
D. Dysrhythmias: Haloperidol can prolong the QT interval on an electrocardiogram (ECG), leading to an increased risk of dysrhythmias, including torsades de pointes. This risk is particularly important in clients with preexisting cardiovascular conditions or those taking other medications that can prolong the QT interval. Therefore, nurses should monitor clients receiving haloperidol for signs of dysrhythmias, including palpitations, dizziness, and syncope, and promptly report any abnormalities to the healthcare provider.
Correct Answer is B
Explanation
A. Hearing loss: Alprazolam, a benzodiazepine medication, is not typically associated with hearing loss. Adverse effects related to hearing are not commonly reported with the use of alprazolam.
B. Insomnia: Insomnia, or difficulty falling or staying asleep, is a potential adverse effect of alprazolam. While benzodiazepines like alprazolam are central nervous system depressants and can cause drowsiness, paradoxical reactions such as insomnia may occur in some individuals.
C. Bradycardia: Alprazolam is not known to cause bradycardia. Instead, it may cause mild tachycardia or irregular heart rhythms as potential cardiovascular side effects.
D. Hypertension: Alprazolam is more likely to cause hypotension (low blood pressure) rather than hypertension. Hypotension is a potential adverse effect due to its central nervous system depressant effects, which can lead to relaxation of blood vessels and decreased blood pressure.
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