An adult diagnosed with schizophrenia was started on clozapine (Clozaril) 4 days ago
At 2100 today, the patient's vital signs are temperature 101° F; pulse 143 beats/min; respirations 20 breaths/min; blood pressure 100/60 mm Hg. What is the nurse's best action regarding the 2100 dose of clozapine?
a. Recognize the alterations in vital signs as typical for early therapy, and administer the medication.
b. Hold the medication, and notify the health care provider.
c. Give the drug and continue to monitor vital signs every 4 hours.
d. Postpone the dose until vital signs are normal.
B
Clozapine might cause agranulocytosis, a potentially fatal illness. Any symptoms or signs of infection raise suspicion and call for investigation of white cell differential counts. Clozapine should be withheld until the white blood cell (WBC) count and absolute neutrophil count (ANC) are known. Administering the drug has the potential for further lowering the WBC count and ANC.
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