Schizophrenia Q 24
A client with schizophrenia is receiving antipsychotic medication. Which nursing diagnosis may be appropriate for this client?
A. Ineffective protection related to blood dyscrasias
B. Urinary frequency related to adverse effects of antipsychotic medication
C. Risk for injury related to a severely decreased level of consciousness
D. Risk for injury related to electrolyte disturbances
Correct Answer: A. Ineffective protection related to blood dyscrasias
Antipsychotic medications may cause neutropenia and granulocytopenia, life-threatening blood dyscrasias, that warrant a nursing diagnosis of Ineffective protection related to blood dyscrasias. These medications also have anticholinergic effects, such as urine retention, dry mouth, and constipation. Leukopenia, thrombocytopenia, and blood dyscrasia are rare side effects of treatment with FGAs.
Option B: Urinary frequency isn’t an approved nursing diagnosis. First-generation antipsychotics (FGAs) are associated with significant extrapyramidal side effects. Anticholinergic adverse effects like dry mouth, constipation, urinary retention are common with low potency dopamine receptor antagonists like chlorpromazine, thioridazine.
Option C: Although antipsychotic medications may cause sedation, they don’t severely decrease the level of consciousness. The action of H1 histamine blocking by First-generation antipsychotics causes sedation. Chlorpromazine is the most sedating, while fluphenazine, haloperidol, and pimozide are less sedating. First-generation antipsychotics can also lower the seizure threshold, and chlorpromazine and thioridazine are more epileptogenic than others.
Option D: These drugs don’t cause electrolyte disturbances. Neuroleptic malignant syndrome is a rare but fatal adverse effect that can occur at any time during treatment with FGAs. The onset of symptoms is over 24 to 72 hours with increased temperature, severe muscular rigidity, confusion, agitation, elevation in white blood cell count, elevated creatinine phosphokinase concentrations, elevated liver enzymes, myoglobinuria, and acute renal failure.