A client receives his first dose of fluphenazine. The next day, he comes in from sitting outside, and the nurse observes that he is confused. His temperature is 103°F
His pulse rate is 116 beats per minute, and his respirations are 34 breaths per minute. His blood pressure is 100/50 mm Hg. What does the nurse suspect?
A) Anaphylaxis
B) Serotonin syndrome
C) Neuroleptic malignant syndrome
D) Parkinsonism
Ans: C
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The most serious and potentially fatal side effect of the typical antipsychotics is neuroleptic malignant syndrome, characterized by severe muscular rigidity, altered consciousness, disorientation, dysphagia, elevated creatinine phosphokinase, stupor, catatonia, hyperpyrexia, and labile pulse and blood pressure. This life-threatening condition can occur after a single dose of a neuroleptic; however, it is more common in the first 2 weeks of administration or with an increase in dose. It can continue for up to 2 weeks after discontinuation of the medication.
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