NCLEX REVIEW UWORLD-2021/2022

• Clozapine is an atypical antipsychotic medication used to treat schizophrenia that has not responded to standard, more traditional treatment. Clozapine is associated with a risk for agranulocytosis and is therefore used only in clients with treatment-resistant schizophrenia. must have their WBC and ANC monitored regularly throughout the course of therapy (initially once every week). the health care provider (HCP) immediately if fever or a sore throat develops, as this may indicate an underlying infection from neutropenia. also cause metabolic syndrome (weight gain, hyperlipidemia, insulin resistance/diabetes) and seizures. • Weight gain—a baseline height, weight, and waist circumference should be obtained, and a BMI can be calculated • Hyperglycemia—symptoms of hyperglycemia (eg, increased thirst and urination, weakness, increased blood glucose) should be monitored • Dyslipidemia—a lipid profile should be obtained A hemorrhagic stroke occurs when a blood vessel ruptures in the brain and causes bleeding into the brain tissue or subarachnoid space. Seizure activity may occur due to increased intracranial pressure (ICP) (Option 3). During the acute phase, a client may develop dysphagia. To prevent aspiration, the client must remain NPO until a swallow function screen reveals no deficits (Option 4). The nurse should perform neurological assessments (eg, level of consciousness, pupillary response) at regular intervals and report any acute changes (Option 5). Preventing activities that increase ICP or blood pressure will minimize further bleeding. The nurse should: • Reduce stimulation, maintain a quiet and dimly lit environment, limit visitors • Administer stool softeners to reduce strain during bowel movements (Option 1) • Reduce exertion, maintain strict bed rest, assist with activities of daily living • Maintain head in midline position to improve jugular venous return to the heart Sulfonylureas (eg, glyburide) stimulate insulin release via the pancreas and carry a risk for severe and prolonged hypoglycemia in the geriatric population due to potential delayed elimination. Avoidance of these drugs is recommended by the Beers Criteria. Instead, other medications that are at lower risk for hypoglycemia should be used (eg, metformin) Nephrotic syndrome, an autoimmune disease, affects children age 2-7 and is characterized by increased permeability of the glomerulus to proteins (eg, albumin, immunoglobulins, natural anticoagulants). Loss of albumin in urine leads to hypoalbuminemia; this causes decreased plasma oncotic pressure, which allows fluid to leak out of the vascular spaces. Reduced plasma volume (hypovolemia) activates kidneys to retain salt and water (renin-angiontensin-aldosterone system). Clients will have generalized edema, weight gain, loss of appetite (from ascites), and decreased urine output. Loss of immunoglobulins makes children susceptible to infection. Treatment typically includes: • Corticosteroids and other immunosuppressants (eg, cyclosporine) • Loss of appetite management by making foods fun and attractive • Infection prevention (eg, limiting social interaction until the child is better) Nephrotic syndrome is a collection of symptoms resulting from various causes of glomerular injury. Below are the 4 classic manifestations of nephrotic syndrome: