A nurse is caring for a client diagnosed with severe manifestations of schizophrenia and is prescribed haloperidol (Haldol) PRN for agitation. The nurse should recognize which of the following as adverse effects of haloperidol (Haldol)?

The correct answer is: A, D, E, and F.

Choice A reason:

Muscular tension, blood pressure, and triglycerides increase. Long-term stress can lead to chronic muscle tension, elevated blood pressure, and increased triglyceride levels. Chronic muscle tension is a common response to prolonged stress, often resulting in pain and discomfort. Elevated blood pressure is a well-documented effect of chronic stress, which can increase the risk of cardiovascular diseases. Increased triglycerides are also associated with prolonged stress, contributing to metabolic syndrome and cardiovascular risk.

Choice B reason:

Epinephrine is released, increasing heart and respiratory rates. This response is more characteristic of acute stress rather than long-term stress. Epinephrine (adrenaline) is released during the “fight-or-flight” response, causing immediate increases in heart rate and respiratory rate. However, this is a short-term physiological response and not typically sustained over long periods.

Choice C reason:

Corticosteroid release increases stamina and impedes digestion. While corticosteroids like cortisol are released during stress, their primary long-term effect is not to increase stamina but to manage energy by increasing blood glucose levels through gluconeogenesis. Chronic cortisol release can indeed impede digestion by diverting energy away from non-essential functions like the digestive system.

Choice D reason:

Cortisol is released, increasing gluconeogenesis and reducing fluid loss. Cortisol, a key stress hormone, is released during long-term stress and increases gluconeogenesis, which is the production of glucose from non-carbohydrate sources. This helps maintain energy levels during prolonged stress. Cortisol also helps in reducing fluid loss by promoting sodium retention in the kidneys.

Choice E reason:

Immune system functioning decreases, and risk of cancer increases. Chronic stress can suppress the immune system, making the body more susceptible to infections and diseases. Prolonged immune suppression can also increase the risk of cancer as the body’s ability to detect and destroy abnormal cells is compromised.

Choice F reason:

Risk of depression, autoimmune disorders, and heart disease increases. Long-term stress is linked to an increased risk of depression and other mental health disorders due to the continuous release of stress hormones affecting brain function. It can also trigger autoimmune disorders by causing chronic inflammation and dysregulation of the immune system. Additionally, the persistent high levels of stress hormonees can lead to heart disease by promoting hypertension and other cardiovascular issues.

Choice A reason:

Acute dystonia is characterized by sudden muscle contractions that can cause abnormal postures. While it is an adverse effect of antipsychotic medications, the symptoms typically include muscle spasms, stiffness, and oculogyric crisis, but not necessarily fever and diaphoresis.

Choice B reason:

Tardive dyskinesia is a late-onset movement disorder associated with prolonged use of antipsychotic medications. It presents with repetitive, involuntary, and purposeless movements, such as grimacing, tongue movements, and lip smacking. Fever and blood pressure changes are not typical features of tardive dyskinesia.

Choice C reason:

Pseudoparkinsonism is an adverse effect of antipsychotic medications that mimics the symptoms of Parkinson's disease, such as tremor, rigidity, bradykinesia, and postural instability. However, it does not usually present with fever or diaphoresis.

Choice D reason:

Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic emergency associated with the use of antipsychotic medications. It is characterized by mental status changes, muscle rigidity, fever, and autonomic dysfunction, such as blood pressure changes and diaphoresis. NMS requires immediate medical attention and discontinuation of the offending agent.