Psychotic Disorders no. 4060

Psychotic Disorders no. 4060

QUESTION: For several years, a client with chronic schizophrenia has received 10 mg of fluphenazine hydrochloride (Prolixin) by mouth four times per day. Now the client has a temperature of 102<font face="LWWSYM">%</font> F (38.9<font face="LWWSYM">%</font> C), a heart rate of 120 beats/minute, a respiratory rate of 20 breaths/minute, and a blood pressure of 210/140 mm Hg. Because the client also is confused and incontinent, the nurse suspects malignant neuroleptic syndrome. What steps should the nurse take?

✘O a.) Give the next dose of fluphenazine, call the physician, and monitor vital signs.
✓O b.) Withhold the next dose of fluphenazine, call the physician, and monitor vital signs.
✘O c.) Give the next dose of fluphenazine and restrict the client to the room to decrease stimulation.
✘O d.) Withhold the next dose of fluphenazine, administer an antipyretic agent, and increase the client's fluid intake.

RATIONALE

RATIONALE: Malignant neuroleptic syndrome is a dangerous adverse effect of neuroleptic drugs such as fluphenazine. The nurse should withhold the next dose, notify the physician, and continue to monitor vital signs. Although an antipyretic agent may be used to reduce fever, increased fluid intake is contraindicated because it may increase the client's fluid volume further, raising blood pressure even higher.
NURSING PROCESS STEP: Implementation
CLIENT NEEDS CATEGORY: Physiological integrity
CLIENT NEEDS SUBCATEGORY: Physiological adaptation
COGNITIVE LEVEL: Application