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

Answer and Explanation

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 B

Explanation

A. Avoid flossing the teeth to prevent gum irritation: There is no evidence to suggest that flossing the teeth increases the risk of gum irritation with phenytoin use. In fact, proper dental hygiene, including flossing, is essential to prevent gum disease, which can be exacerbated by the medication.

B. Alcohol increases the chance of phenytoin toxicity: Consumption of alcohol can increase the risk of phenytoin toxicity by enhancing its effects. Therefore, clients taking phenytoin should avoid alcohol consumption to prevent adverse effects and ensure the medication's efficacy.

C. Take an antacid with the medication if indigestion occurs: Phenytoin can interact with antacids, reducing its absorption and effectiveness. Therefore, clients should not take antacids concurrently with phenytoin unless directed by their healthcare provider.

D. Phenytoin turns urine blue: Phenytoin does not typically cause changes in urine color. This statement is incorrect and not relevant to the client's medication regimen.

A. Dilute the medication with sterile water before injecting. B. Administer the medication over 1 min. C. Slow the injection if the medication crystallizes. D. Follow the IV injection with sterile water.

Correct Answer is B

Explanation

A. Dilute the medication with sterile water before injecting: Phenytoin should not be diluted before administration because it may cause precipitation or crystallization of the drug, leading to potential adverse effects such as tissue irritation or embolism.

B. Administer the medication over 1 min: Phenytoin should be administered slowly over 1 to 2 minutes to reduce the risk of adverse effects such as hypotension or cardiac arrhythmias. Rapid infusion can lead to cardiovascular collapse.

C. Slow the injection if the medication crystallizes: If the medication crystallizes, the nurse should stop the injection immediately and flush the IV line with normal saline. However, preventing crystallization by administering the medication slowly over the recommended time is preferable.

D. Follow the IV injection with sterile water: Following the IV injection with sterile water is not a standard practice for administering phenytoin. Instead, the nurse should follow institutional guidelines for flushing the IV line after medication administration, typically with normal saline.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Explanation

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