QLexNursing

🧠 ✅ Instruct client to use sugarless gum or hard candy

🧠 Clozapine commonly causes anticholinergic side effects, including dry mouth (xerostomia).

🧠 Using sugarless gum or hard candy stimulates salivation, helping relieve oral dryness and discomfort.

🧠 Managing dry mouth is important to reduce the risk of dental caries, oral infections, and difficulty swallowing.

🧠 This education promotes comfort while preventing secondary complications associated with chronic xerostomia.

🧠 ✅ Encourage the client to engage in regular physical activity

🧠 The client has experienced a significant weight gain of 13.7 kg (30.1 lb) in 6 months, a common adverse effect of second-generation antipsychotics, including clozapine.

🧠 Clozapine increases risk for metabolic syndrome, insulin resistance, and type 2 diabetes, which explains the addition of metformin to the regimen.

🧠 Regular physical activity helps manage weight, blood glucose levels, and cardiovascular risk.

🧠 Teaching lifestyle modification is essential to long-term health and medication adherence.

🧠 ✅ Educate client to have neutrophil count drawn every month

🧠 Clozapine carries a serious risk of agranulocytosis, a potentially life-threatening reduction in neutrophils.

🧠 This client’s absolute neutrophil count (ANC) has dropped to 1,500/mm³, which is below the normal reference range and requires close monitoring.

🧠 Monthly ANC monitoring is mandatory to detect early neutropenia and prevent severe infection.

🧠 Education empowers the client to comply with required laboratory monitoring and recognize infection risk.

❌ Topics NOT Appropriate to Include (Elaborated):

❌ Instruct the client to continue taking clozapine

❌ Explanation:

❌ The client presents with fever, sore throat, body aches, and fatigue, which are classic warning signs of clozapine-induced neutropenia or infection.

❌ With a declining ANC and signs of infection, the priority is immediate evaluation, not reassurance to continue the medication.

❌ Nurses should never independently instruct continuation of clozapine when agranulocytosis is suspected.

❌ The provider must evaluate and determine whether the medication should be held or adjusted.

❌ Teach the client about healthy high-calorie snacks

❌ Explanation:

❌ The client already has central abdominal weight gain, indicating increased metabolic risk.

❌ High-calorie snacks—even if “healthy”—would worsen weight gain, insulin resistance, and cardiovascular risk.

❌ Education should instead focus on balanced nutrition, portion control, and weight management.

❌ This teaching contradicts the client’s current clinical needs.