Question

A client with schizophrenia has been taking Thorazine (chlorpromazine) 200mg four times a day. Which finding should be reported to the doctor immediately? A. The client complains of thirst B. The client has gained 4 pounds in the past 2 months C. The client complains of a sore throat D. The client naps throughout the day

Short answer

A) The client complains of thirst. B) The client has gained 4 pounds in the past 2 months. C) The client complains of a sore throat. D) The client naps throughout the day. Answer: C) The client complains of a sore throat.

Step-by-step solution

Identify possible side effects of Thorazine (chlorpromazine)

To solve this problem, first, research the common and severe side effects of Thorazine (chlorpromazine) to better understand which finding requires immediate attention.

Analyze each option

Next, analyze each finding (option A, B, C, and D) and determine if it aligns with any of the known side effects of Thorazine. Keep in mind, we're looking for the side effect that should be reported immediately. Option A: The client complains of thirst. Thirst could be a side effect of the medication, but it's a common and mild side effect that doesn't require immediate attention. Option B: The client has gained 4 pounds in the past 2 months. Weight gain is a common side effect but again, it is not considered severe or requiring immediate attention. Option C: The client complains of a sore throat. A sore throat could potentially be a sign of agranulocytosis, which is a severe and potentially life-threatening side effect of antipsychotic medications, including Thorazine. Agranulocytosis is characterized by a decrease in white blood cells, which can cause a higher susceptibility to infections, including those in the throat. Option D: The client naps throughout the day. Drowsiness is a common side effect of Thorazine and doesn't require immediate attention.

Determine which finding should be reported immediately

Given the information we have about each of the side effects, Option C, "The client complains of a sore throat," should be reported to the doctor immediately due to the potential of developing agranulocytosis.

Key concepts

Side Effects of Thorazine

Thorazine, also known as chlorpromazine, is a medication used to treat schizophrenia and other psychotic disorders. Understanding its side effects is crucial for both healthcare providers and patients. Some common side effects include drowsiness, dry mouth, constipation, and blurred vision. However, there are more serious side effects that require immediate medical attention.

Agranulocytosis

A critical side effect to be aware of is agranulocytosis, which is a reduction in the number of white blood cells. This condition can significantly increase the risk of infections. Symptoms suggesting agranulocytosis include sore throat, fever, and infections, which should not be taken lightly and warrant urgent medical intervention.

Neurological Side Effects

Additionally, Thorazine can cause neurological side effects such as tardive dyskinesia, a condition involving involuntary movements, or Neuroleptic Malignant Syndrome (NMS), characterized by muscle rigidity, fever, and altered mental status, which is life-threatening. For these reasons, monitoring any changes in a patient's condition is imperative.

Antipsychotic Medication Monitoring

When a patient is on an antipsychotic medication like Thorazine, rigorous monitoring is vital to ensure safety and efficacy. Healthcare providers should perform regular blood tests to monitor white blood cell counts, especially during the first few months of treatment or when the dosage is changed.

Other tests may include electrocardiograms (EKG) to check for any heart abnormalities, and liver function tests since antipsychotic medications can affect liver enzymes. Additionally, patients should have their weight, blood pressure, and glucose levels checked regularly, as antipsychotics can influence these parameters, potentially leading to metabolic syndrome.Educating patients about the importance of reporting any unusual symptoms or changes in their condition, such as a sore throat or fever, contributes significantly to effective monitoring and timely intervention.

Nursing Intervention Priorities

Nurses play a pivotal role in the care of patients taking antipsychotic medications. Prioritizing interventions for these patients begins with thorough education on potential side effects and the importance of adhering to the medication regimen.

Maintaining Vigilance

Nurses should maintain vigilant observation for signs of serious side effects like agranulocytosis, tardive dyskinesia, and NMS. They should also assess for more common but less serious effects such as weight gain, sedation, and anticholinergic effects.

Patient Advocacy

As patient advocates, nurses are often the first to notice subtle changes in a patient's condition and can be instrumental in advocating for a prompt medical evaluation when necessary. They also manage day-to-day care, noting any unusual symptoms and reinforcing the importance of regular lab work and physician appointments.Nurses also coordinate with other healthcare professionals to ensure a comprehensive approach to monitoring and addressing side effects of antipsychotic medications.