the laboratory report for a patient taking clozapine (clozaril) shows a white blood cell count of

An uncommon but serious side effect of clozapine is severe neutropenia, defined as an absolute neutrophil count (ANC) less than 500/μL. Neutrophils are a type of white blood cell that combats infection.

Full Answer

What is the laboratory report for a patient taking clozapine (Clozaril)?

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm3. Select the nurse’s best action. a. Report the results to the health care provider immediately. b. Administer the next dose as prescribed. c. Give aspirin and force fluids. d. Repeat the laboratory test.

What is the white blood cell count for clozapine?

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm3. Select the nurse’s best action. a. Report the results to the health care provider immediately.

How many patients does a nurse care for on clozapine?

A nurse cares for four patients who are receiving clozapine, lithium, fluoxetine, and venlafaxine, respectively. With which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

What is the difference between clozapine and chlordiazepoxide?

Clozapine is an antipsychotic. Chlordiazepoxide is an anxiolytic. Tacrine treats Alzheimer’s disease. 15 A patient diagnosed with bipolar disorder has an unstable mood, aggressiveness, agitation, talkativeness, and irritability. The nurse expects the health care provider to prescribe a medication from which group? a.

How does clozapine affect white blood cells?

The most serious side effect associated with CLOZARIL is called agranulocytosis. This occurs when your white blood cell count is significantly lowered and your body's immune system becomes highly vulnerable to infection.

What lab values does clozapine effect?

The US Food and Drug Administration requires patients in the United States to have a minimum absolute neutrophil count (ANC) greater than or equal to 1500/microL to initiate clozapine [1]. An exception is made for patients with benign ethnic neutropenia, who are subject to a lower ANC level.

Can clozapine cause high WBC?

Unfortunately, clozapine is also associated with a number of adverse effects, with agranulocytosis being one of the chief concerns. Interestingly, patients who receive clozapine treatment may occasionally experience elevations in their total white blood cell count (WBC).

Does clozapine lower WBC?

The stable but low total WBC and neutrophil counts during clozapine therapy can, with hindsight, be explained as being due to a constant but mild clozapine-induced suppression of WBCs during the 19 years of clozapine treatment.

Does clozapine cause high platelets?

Clozapine is known to cause blood dyscrasias, typically neutropenia and agranulocytosis. A raised platelet count, with clozapine as the sole implicated agent, had been reported to the Committee on Safety of Medicines in three cases.

Does clozapine cause neutropenia?

Clozapine can induce two clinically distinct types of neutropenia [19]. The first type is a mild to moderate neutropenia (neutrophil count below 1.5 ∗ 103/μL but not lower than 0.5 ∗ 103/μL) which occurs in 1.8% of treated patients. When clozapine is discontinued, recovery is rapid (2–8 days).

Can clozapine cause leukopenia?

Clozapine is one of the oldest antipsychotic medications and has been proven to be successful for treatment-resistant schizophrenia. However, unlike newer antipsychotic medications, clozapine has been associated with many adverse events (AEs) including neutropenia and leukopenia, which may lead to agranulocytosis.

Does clozapine cause Neutrophilia?

(5) Instead of agranulocytosis, most patients treated with clozapine have an increase in the number of immature neutrophils in the circulation (6) and an elevated total neutrophil count. (7) This neutrophilia is associated with an immune response and an increase in inflammatory cytokines such as IL-6.

What causes leukocytosis?

Leukocytosis is most commonly caused by infection or inflammation. Other high white blood cell count causes may include: Excessive physical or emotional stress (such as fever, injury or surgery). Burns.

What is neutrophils in blood test high?

Having a high percentage of neutrophils in your blood is called neutrophilia. This is a sign that your body has an infection. Neutrophilia can point to a number of underlying conditions and factors, including: infection, most likely bacterial. noninfectious inflammation.

What should WBC count be?

The normal number of WBCs in the blood is 4,500 to 11,000 WBCs per microliter (4.5 to 11.0 × 109/L). Normal value ranges may vary slightly among different labs. Some labs use different measurements or may test different specimens. Talk to your provider about your test results.

What is the side effects of Clozaril?

Drooling, drowsiness, dizziness, lightheadedness, headache, shaking (tremor), vision problems (such as blurred vision), constipation, and weight gain may occur. Many of these effects (especially drowsiness) lessen as your body gets used to the medication.

A patient asks, “What are neurotransmitters? The doctor said mine are imbalanced.” Select the nurse’s best response. a. “How do you feel about having imbalanced neurotransmitters?” b. “Neurotransmitters protect us from harmful effects of free radicals.” c. “Neurotransmitters are substances we consume that influence memory and mood.” d. “Neurotransmitters are natural chemicals that pass messages between brain cells.”

D: The patient asked for information, and the correct response is most accurate. Neurotransmitters are chemical substances that function as messeng...

The parent of an adolescent diagnosed with schizophrenia asks the nurse, “My child’s doctor ordered a PET. What kind of test is that?” Select the nurse’s best reply. a. “This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?” b. “PET means positron-emission tomography. It is a special type of scan that shows blood flow and activity in the brain.” c. “A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures.” d. “It’s a special x-ray that shows structures of the brain and whether there has ever been a brain injury.”

B: The parent is seeking information about PET scans. It is important to use terms the parent can understand, so the nurse should identify what the...

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer’s disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first? a. Skull x-rays b. Computed tomography (CT) scan c. Positron-emission tomography (PET) d. Single-photon emission computed tomography (SPECT)

B: A CT scan shows the presence or absence of structural changes, including cortical atrophy, ventricular enlargement, and areas of infarct, inform...

A patient’s history shows drinking 4 to 6 liters of fluid and eating more than 6,000 calories per day. Which part of the central nervous system is most likely dysfunctional for this patient? a. Amydala b. Parietal lobe c. Hippocampus d. Hypothalamus

D: The hypothalamus, a small area in the ventral superior portion of the brainstem, plays a vital role in such basic drives as hunger, thirst, and...

The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient? a. “Have you ever seen or heard things that others do not?” b. “What are your worst and best times of the day?” c. “How would you describe your thinking?” d. “Do you think your memory is failing?”

B: Mood changes throughout the day may be related to circadian rhythm disturbances. Questions about sleep pattern are also relevant to circadian rh...

The nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which effect would be expected? a. Reduced anxiety b. Improved memory c. More organized thinking d. Fewer sensory perceptual alterations

A: Increased levels of GABA reduce anxiety. Acetylcholine and substance P are associated with memory enhancement. Thought disorganization is associ...

A nurse would anticipate that treatment for a patient with memory difficulties might include medications designed to: a. inhibit gamma-aminobutyric acid (GABA). b. prevent destruction of acetylcholine. c. reduce serotonin metabolism. d. increase dopamine activity.

B: Increased acetylcholine plays a role in learning and memory. Preventing destruction of acetylcholine by acetylcholinesterase would result in hig...

A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain? a. Hippocampus b. Frontal lobe c. Cerebellum d. Brainstem

B: The frontal lobe is responsible for intellectual functioning. The hippocampus is involved in emotions and learning. The cerebellum regulates ske...

The nurse should assess a patient taking a drug with anticholinergic properties for inhibited function of the: a. parasympathetic nervous system. b. sympathetic nervous system. c. reticular activating system. d. medulla oblongata.

A: Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic nervous system. When anticholinergic drugs inhibit acet...

What medications are used in hospital for depression?

Of the medications listed below, the nurse can expect to provide the patient with teaching about:#N#a. chlordiazepoxide (Librium).#N#b. clozapine (Clozaril ).#N#c. sertraline (Zoloft ).#N#d. tacrine (Cognex).

What is the nurse's reply to Paxil?

I assume I’ll have side effects like I had when I was taking Tofranil (imipramine).” The nurse’s reply should be based on the knowledge that paroxetine is a (n):#N#a. selective norepinephrine reuptake inhibitor.#N#b. tricyclic antidepressant.#N#c. MAO inhibitor.#N#d. SSRI.

What happens to the synaptic gap when the reuptake of a substance is inhibited?

B: If the reuptake of a substance is inhibited, it accumulates in the synaptic gap, and its concentration increases, permitting ease of transmission of impulses across the synaptic gap. Normal transmission of impulses across synaptic gaps is consistent with normal rather than depressed mood.

What are the therapeutic actions of neurotransmitter inhibitors that block reuptake?

The therapeutic action of neurotransmitter inhibitors that block reuptake cause:#N#a. decreased concentration of the blocked neurotransmitter in the central nervous system .#N#b. increased concentration of the blocked neurotransmitter in the synaptic gap .#N#c. destruction of receptor sites specific to the blocked neurotransmitter.#N#d. limbic system stimulation.

What is PET scan?

It is a special type of scan that shows blood flow and activity in the brain. ”. c. “A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures.”. d. “It’s a special x-ray that shows structures of the brain and whether there has ever been a brain injury.”.

What is the meaning of neurotransmitter?

d. “Neurotransmitters are natural chemicals that pass messages between brain cells. ”. D: The patient asked for information, and the correct response is most accurate. Neurotransmitters are chemical substances that function as messengers in the central nervous system. They are released from the axon terminal, diffuse across the synapse, ...

Why do you need to take a low tyramine diet?

C: Patients taking MAO-inhibiting drugs must be on a low tyramine diet to prevent hypertensive crisis. In the presence of MAO inhibitors, tyramine is not destroyed by the liver and in high levels produces intense vasoconstriction, resulting in elevated blood pressure.