Final answer:
The nurse should assess vitals, review the patient's history, check white blood cell count due to the risk of agranulocytosis associated with clozapine, and report to the healthcare provider. Immediate attention is also advised for David who may have rabies, and Barbara's treatment plan for pneumonia may need review if not improved with amoxicillin.
Step-by-step explanation:
The patient's symptoms of lethargy and myalgia after taking clozapine for several months are concerning and could be indicative of potential side effects or complications associated with the medication. The nurse should perform an immediate assessment of the patient's vitals, inquire about any additional symptoms, and review the patient's medical history. It is of the utmost importance to check the patient's white blood cell count, as clozapine can cause agranulocytosis, a potentially life-threatening drop in white blood cells, leading to a weakened immune system and increased susceptibility to infection. Subsequently, the nurse should promptly report the findings to the healthcare provider for further evaluation and possible alteration of the patient's medication regimen.
For the other cases mentioned, if David is experiencing symptoms that could be related to rabies from a dog bite, prompt medical attention is critical as it is an acute viral disease that can lead to serious complications if not treated immediately. If Barbara's condition isn't improving with amoxicillin, it may be necessary to re-evaluate her treatment plan for pneumonia.
In the case of the elderly woman who experienced changes in motor control due to medication side effects, regions of the nervous system likely affected by haloperidol include areas responsible for motor control such as the basal ganglia and cerebellum. This should be a consideration in the present clinical scenario when reviewing potential side effects of clozapine.