Question

Kyle, a 23-year-old patient with schizophrenia, has been admitted to the psychiatric unit for one week. He has begun to take the first-generation antipsychotic haloperidol (Haldol). One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay he seems unable to turn towards you or to respond verbally. You obtain vital signs, which are as follows: BP 170/100, P 110, T 103. What are the priority nursing interventions?

A) Administer a prn dose of haloperidol
B) Encourage Kyle to move around and stretch
C) Monitor vital signs closely and notify the healthcare provider
D) Document the findings and continue routine care

Answer 1

The priority nursing interventions for Kyle, a patient with schizophrenia experiencing side effects from haloperidol, include monitoring vital signs closely, notifying the healthcare provider, and avoiding administering additional medication.

Step-by-step explanation:

The priority nursing interventions for Kyle, a 23-year-old patient with schizophrenia who is experiencing stiff movements and reduced responsiveness after taking the antipsychotic haloperidol, would be to:

1. Monitor vital signs closely and notify the healthcare provider: Kyle's high blood pressure, increased heart rate, and elevated temperature indicate a potential medical emergency, which requires immediate attention.
2. Document the findings and continue routine care: While it's important to document the patient's condition, the priority is to ensure timely medical intervention due to the potentially serious side effects of the medication.
3. Avoid administering a prn dose of haloperidol: Given Kyle's current symptoms, it is advisable to withhold any further administration of the medication until he has been assessed by the healthcare provider.