A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection?

Clozapine is an antipsychotic medication that is used to treat schizophrenia and other psychotic disorders. It works by affecting the balance of certain chemicals in the brain.

Choice A is wrong because clozapine can cause weight gain, not weight loss, in some people. This can increase the risk of diabetes, high cholesterol, and heart problems. The nurse should advise the client to monitor their weight regularly and to follow a healthy diet and exercise plan.

Choice B is wrong because ringing in the ears (tinnitus) is not an expected adverse effect of clozapine. However, clozapine can cause other ear problems, such as otitis media (middle ear infection) or otitis externa (outer ear infection). The nurse should instruct the client to report any ear pain, discharge, or hearing loss to their provider.

Choice D is wrong because diarrhoea is not a common adverse effect of clozapine. However, clozapine can cause constipation, which can be severe and lead to bowel obstruction or perforation. The nurse should advise the client to drink plenty of fluids, eat high-fibre foods, and use laxatives as prescribed by their provider.

Choice C is correct because fever is a serious adverse effect of clozapine that may indicate a life-threatening condition called

agranulocytosis. Agranulocytosis is a severe reduction in white blood cells that can impair the immune system and increase the risk of infections. The nurse should instruct the client to notify their provider immediately if they develop a fever or any signs of infection, such as sore throat, cough, or flu-like symptoms. The client should also have regular blood tests to monitor their white blood cell count while taking clozapine.

Medication reconciliation is the process of creating the most accurate list possible of all medications a client is taking and comparing that list against the physician’s orders at every transition of care. A client who is transferred to a step-down unit is at risk of medication errors due to changes in the level of care and the prescribing providers. Therefore, medication reconciliation should be performed for this client to prevent adverse drug events.

Choice A is wrong because a referral for social services does not involve a change in the client’s medications or care setting.

Choice B is wrong because transport to radiology is a temporary and short-term movement that does not require medication reconciliation.

Choice D is wrong because a consultation for physical therapy does not affect the client’s medication regimen or orders.