A nurse is providing discharge teaching to a client who has schizophrenia and is starting therapy with clozapine. Which of the following is the highest priority for the client to report to the provider?
Blurred vision
Dry mouth
Fever
Constipation
The Correct Answer is C
A. Blurred vision: Blurred vision can occur as a side effect of clozapine due to anticholinergic properties. While it may cause discomfort or temporary visual disturbances, it is not immediately life-threatening and does not require urgent reporting to the provider.
B. Dry mouth: Dry mouth is a common and expected anticholinergic side effect of clozapine. Although it can contribute to dental issues if persistent, it does not indicate a serious or emergent complication and can often be managed with hydration or saliva substitutes.
C. Fever: Fever is the highest priority symptom to report because it can indicate agranulocytosis, a rare but potentially life-threatening side effect of clozapine. Agranulocytosis compromises the immune system, increasing the risk of severe infections, making early detection and intervention critical.
D. Constipation: Constipation is a common side effect due to clozapine’s anticholinergic effects. While it should be monitored and managed to prevent complications such as bowel obstruction, it is not immediately life-threatening compared to signs of infection like fever.
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Related Questions
Correct Answer is D
Explanation
A. Candidiasis: Candidiasis is a common fungal infection and is not a nationally notifiable disease. Reporting to the CDC is not required for routine cases.
B. Pelvic inflammatory disease: PID is a complication of sexually transmitted infections, but it itself is not a reportable condition. The underlying infection, if it is a notifiable STI, may need to be reported instead.
C. Methicillin-resistant Staphylococcus aureus: MRSA infections acquired in the community or healthcare settings are not universally reportable to the CDC. Reporting requirements vary by state, but MRSA is generally monitored rather than mandatorily reported nationally.
D. Syphilis: Syphilis is a nationally notifiable sexually transmitted infection. Cases must be reported to local and state health departments, which then notify the CDC. This allows for public health tracking, contact tracing, and prevention of further transmission.
Correct Answer is C
Explanation
A. Keep the head of the client's bed at a 15° angle: Elevating the head of the bed only slightly is insufficient for optimal lung expansion. A higher elevation, usually 30–45°, is recommended to improve ventilation and ease breathing during an exacerbation.
B. Place the client on bedrest for 24 hr: Prolonged bedrest can decrease lung expansion and increase the risk of mucus retention. Encouraging activity as tolerated helps maintain respiratory function and prevents complications.
C. Instruct the client to increase fluid intake to 2.5 L per day: Increased fluid intake helps thin secretions, making them easier to expectorate. This is a key intervention in managing an acute exacerbation of chronic bronchitis to improve airway clearance.
D. Encourage the client to perform deep-breathing exercises every 6 hr: Deep-breathing exercises are beneficial, but they should be performed more frequently than every 6 hours, often hourly or as tolerated, to effectively prevent atelectasis and improve oxygenation.
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