A nurse is administering haloperidol to a client who has schizophrenia.
For which of the following adverse effects should the nurse monitor?

Gingival hyperplasia.

Muscle rigidity.

Polyuria.

Bruising.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Gingival hyperplasia is an overgrowth of gum tissue, often associated with certain medications like phenytoin or cyclosporine. It is caused by an increase in the number of fibroblasts and collagen deposition in the gingiva. Haloperidol, an antipsychotic, primarily affects dopamine receptors in the brain and does not cause gingival hyperplasia.

Choice B rationale

Haloperidol is a first-generation antipsychotic that blocks D2 dopamine receptors in the brain. This blockade, particularly in the nigrostriatal pathway, can lead to extrapyramidal symptoms (EPS) such as acute dystonia, parkinsonism (including muscle rigidity, bradykinesia, and tremor), and akathisia. Muscle rigidity is a common manifestation of drug-induced parkinsonism.

Choice C rationale

Polyuria is the excessive production of urine, often a symptom of diabetes mellitus or insipidus. It results from impaired water reabsorption in the kidneys. While some medications can affect fluid balance, haloperidol's primary pharmacological action on dopamine receptors does not directly induce polyuria as a typical adverse effect.

Choice D rationale

Bruising, or ecchymosis, results from bleeding under the skin, often due to trauma or coagulation disorders. It is caused by extravasation of blood from capillaries into surrounding tissues. Haloperidol does not affect coagulation factors or platelet function and is not associated with increased bruising as a direct adverse effect.

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Correct Answer is D

Explanation

Choice A rationale

Androgen therapy can lead to fluid retention, which would typically cause weight gain rather than weight loss. Androgens promote anabolism and can increase muscle mass and erythrocyte production, but they also influence fluid balance by affecting renal sodium and water reabsorption.

Choice B rationale

Androgen therapy generally does not cause hypotension. In some cases, it may lead to a slight increase in blood pressure due to fluid retention and effects on the renin-angiotensin-aldosterone system. Hypotension is not a recognized common adverse effect of androgen therapy.

Choice C rationale

Androgen therapy does promote muscle hypertrophy due to its anabolic effects, increasing protein synthesis and muscle mass. However, this is generally a desired therapeutic effect, not an adverse effect requiring monitoring for cessation, especially when used for conditions like muscle wasting.

Choice D rationale

Androgens can cause fluid retention, leading to edema. This occurs due to their influence on mineralocorticoid receptors in the renal tubules, which promotes sodium and water reabsorption. Nurses should monitor for signs of fluid overload, such as peripheral or pulmonary edema, and changes in body weight.

A. Urine output of 240 mL in a 12-hr period. B. BUN 18 mg/dL (10 to 20 mg/dL). C. Weight loss of 0.61 Kg (1.34 Ib) in 24 hr. D. Blood pressure 100/70 mm Hg.

Correct Answer is C

Explanation

Choice A rationale

A urine output of 240 mL in a 12-hour period translates to 20 mL/hr, which is significantly below the normal physiological range of 30 mL/hr or greater. While low urine output can indicate dehydration, severe oliguria often points to acute kidney injury or severe hypovolemia, not solely dehydration. Normal urine output is generally considered to be 0.5-1 mL/kg/hr.

Choice B rationale

A BUN of 18 mg/dL falls within the normal range of 10 to 20 mg/dL. In dehydration, the kidneys reabsorb more water, leading to a disproportionate increase in BUN relative to creatinine due to increased urea concentration in the tubules, reflecting hypovolemia. A normal BUN value does not indicate dehydration.

Choice C rationale

A weight loss of 0.61 Kg (1.34 lb) in 24 hours is a significant and rapid reduction in body mass. This acute fluid deficit directly reflects a negative fluid balance, indicating a loss of body water. Each kilogram of weight loss approximates 1 liter of fluid loss, making this a clear indicator of dehydration due to fluid volume deficit.

Choice D rationale

A blood pressure of 100/70 mm Hg is within the normal range for many individuals, although it is on the lower side of normotension. While hypotension can be a late sign of severe dehydration, especially orthostatic hypotension, a reading of 100/70 mm Hg alone does not definitively confirm dehydration as the primary cause.

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A nurse is administering haloperidol to a client who has schizophrenia. For which of the following adverse effects should the nurse monitor?

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A nurse is administering haloperidol to a client who has schizophrenia.
For which of the following adverse effects should the nurse monitor?