- (^) ECG Changes.ics. This is particularly true with ziprasidone, thioridazine, c. b. the QT interval, are possible with most of the antipsychot-pimozide, haloperidol, paliperidone, iloperidone, asenapine, Photosensitivityand clozapine. Caution is advised in prescribing these medica-more common with typicals) a. Hormonal effects Ensure that client wears protective sunblock lotion, cloth- Monitor blood pressure (lying and standing) each shift; ing, and sunglasses while spending time outdoors.document and report signifiWeight ga i nproblematic with the atypicals) (men) Decreased libido, retrograde ejaculation, gynecomastiaAmenorrhea* Weigh client every other day; order calorie-controlled Provide explanation of the effects and reassurance of re- Offer reassurance of reversibilit y; instruct client to con-tinue use of contraception, because amenorrhea does diet and exercise instruction.diet; provide opportunity for physical exercise; provide not indicate cessation of ovulation.versibility. If necessary, discuss with physician possibil-ity of ordering alternate medication. (may occur with all classifi (women) ECG changes, including prolongation of (may occur with all classifi (may occur with all classifi cant changes.Antipsychotic Agents cations; has been cations) cations, but ●^497
2 2506_Ch28_472-501.indd 1497 506 Ch 28 472 - 501 .indd 9. 14 97 diuretic therapy or diarrhea, should be taken into consider-ation when prescribing. Routine ECG should be taken before i n it iat ion of t herapy a nd per iod ica l ly du r i ng t herapy. Clozap -ine has also been associated with other cardiac events, such that produce hypokalemia and/or hypomagnesemia, such as as ischemic changes, arrhythmias, congestive heart failure, Reduction of seizure thresholdmyocarditis, and cardiomyopathy.cals than the atypicals, with the exception of clozapine) tions to individuals with history of arrhythmias. Conditions ^ Monitor vital signs every shift. Observe for symptoms of dizziness, palpitations, syncope, Closely observe clients with history of seizures.NOTE:weakness, dyspnea, and peripheral edema.frequently associated. Dose appears to be an important ing clozapine (Clozaril), with which seizures have been clozapine for clients with history of seizures.at higher doses. Extreme caution is advised in prescribing predictor, with a greater likelihood of seizures occurring This is particularly important with clients tak- (more common with typi- 1 10/1/10 9:40:13 AM 0 / 1 / 10 9 : 40 : 13 AM
- (^) ECG Changes.ics. This is particularly true with ziprasidone, thioridazine, c. b. the QT interval, are possible with most of the antipsychot-pimozide, haloperidol, paliperidone, iloperidone, asenapine, Photosensitivityand clozapine. Caution is advised in prescribing these medica-more common with typicals) a. Hormonal effects Ensure that client wears protective sunblock lotion, cloth- Monitor blood pressure (lying and standing) each shift; ing, and sunglasses while spending time outdoors.document and report signifiWeight ga i nproblematic with the atypicals) (men) Decreased libido, retrograde ejaculation, gynecomastiaAmenorrhea* Weigh client every other day; order calorie-controlled Provide explanation of the effects and reassurance of re- Offer reassurance of reversibilit y; instruct client to con-tinue use of contraception, because amenorrhea does diet and exercise instruction.diet; provide opportunity for physical exercise; provide not indicate cessation of ovulation.versibility. If necessary, discuss with physician possibil-ity of ordering alternate medication. (may occur with all classifi (women) ECG changes, including prolongation of (may occur with all classifi (may occur with all classifi cant changes.Antipsychotic Agents cations; has been cations) cations, but ●^497
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