Question

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take?

1) Infuse 0.9
2) Schedule the client for an electroencephalogram
3) Obtain WBC with absolute neutrophil count
4) Place the client on a tyramine-free diet

Answer 1

In response to a client taking clozapine and showing signs of lethargy and myalgia, the nurse should obtain a WBC with absolute neutrophil count to check for agranulocytosis, a serious side effect of the medication.

Step-by-step explanation:

A client who reports lethargy and myalgia after taking clozapine for 6 months may be experiencing symptoms associated with a potentially serious side effect known as agranulocytosis, which is characterized by a dangerously low white blood cell (WBC) count. To address this concern, the appropriate action for the nurse is to obtain a WBC with an absolute neutrophil count (ANC). This test is crucial for monitoring the client's immune function, as clozapine can lead to neutropenia, thereby increasing the risk of infection. If the ANC is found to be significantly low, the clozapine may need to be discontinued and medical intervention initiated.

Administering 0.9% saline infusion, scheduling an electroencephalogram, or placing the client on a tyramine-free diet do not directly address the concerns raised by the symptoms of lethargy and myalgia associated with clozapine use. It is important for healthcare providers to be vigilant for signs of hematological abnormalities in clients taking antipsychotic medications like clozapine, and regular monitoring of the WBC and ANC is recommended.