A nurse is caring for a client who has schizophrenia and is receiving clozapine. For which of the following findings should the nurse monitor to determine if the medication is having a therapeutic effect?
A.
Decreased auditory hallucinations
B.
Control of seizure activity
C.
Weight gain
D.
Decreased WBC count
The Correct answer and Explanation is:
The correct answer is A. Decreased auditory hallucinations.
Explanation
Clozapine is an atypical antipsychotic medication primarily used to treat treatment-resistant schizophrenia. Its therapeutic effects include reducing symptoms such as hallucinations, delusions, and overall psychotic episodes. One of the hallmark symptoms of schizophrenia is auditory hallucinations, where patients hear voices or sounds that are not present. Monitoring for a decrease in auditory hallucinations is crucial because it indicates that the medication is effectively addressing one of the core symptoms of the disorder.
While other options listed may be relevant to the patient’s overall health, they do not directly reflect the primary therapeutic goal of clozapine.
B. Control of seizure activity: Clozapine can lower the seizure threshold, and while monitoring seizure activity is essential, it is not a therapeutic effect of the medication. Instead, it may be a side effect that necessitates caution.
C. Weight gain: Although weight gain can occur with clozapine, it is generally a side effect rather than a therapeutic outcome. Weight management is important for long-term health, but it does not indicate that the medication is successfully treating schizophrenia.
D. Decreased WBC count: Clozapine is associated with agranulocytosis (a significant decrease in white blood cells), which poses a risk of infection. While monitoring white blood cell counts is crucial for safety, a decreased WBC count is not an intended therapeutic effect of clozapine; rather, it’s a serious adverse effect that requires immediate attention.
In summary, the primary goal of clozapine treatment in schizophrenia is to alleviate psychotic symptoms, specifically auditory hallucinations. Monitoring for a decrease in these symptoms is the most direct indicator of therapeutic efficacy for this medication.