A nurse is caring for a client who has schizophrenia in an inpatient facility. Exhibit 1 Medication Administration Record 0730: Clozapine 100 mg PO daily Aripiprazole 5 mg PO daily Multivitamin PO daily Exhibit 2 Laboratory Results 0730: Sodium 125 mEq/L (136 to 145 mEq/L) Potassium 3.5 mEq/L (3.5 to 5.0 mEq/L) Chloride 90 mEq/L (98 to 106 mEq/L) BUN 8 mg/dL (10 to 20 mg
A nurse is caring for a client who has schizophrenia in an inpatient facility.
Exhibit 1
Medication Administration Record
0730:
Clozapine 100 mg PO daily
Aripiprazole 5 mg PO daily
Multivitamin PO daily
Exhibit 2
Laboratory Results
0730:
Sodium 125 mEq/L (136 to 145 mEq/L)
Potassium 3.5 mEq/L (3.5 to 5.0 mEq/L)
Chloride 90 mEq/L (98 to 106 mEq/L)
BUN 8 mg/dL (10 to 20 mg/dL)
Magnesium 1.2 mEq/L (1.3 to 2.1 mEq/L)
Exhibit 3
Vital Signs
1230:
Temperature 37.6° C(99.7°F)
Heart rate 98/min
Respiratory rate 20/min
Blood pressure 142/92 mm Hg
Oxygen saturation 100% on room air
1500:
Temperature 37.1° C(98.8° F)
Heart rate 104/min
Respiratory rate 24/min
Blood pressure 150/90 mm Hg
Oxygen saturation 100% on room air
Exhibit 4
Nurses' Notes
0730:
Client sleeping. Lungs clear to auscultation bilaterally.
Hyperactive bowel sounds noted x 4. Abdomen soft and
nontender. Small bruise noted on right hand. Family at bedside.
Family states client is diagnosed with schizophrenia, and last
doctor's appointment was 6 months ago.
1500:
Client alert and oriented to person and place. Agitated. Speech
disorganized. Client has involuntary tongue movement and foot
tremor. Lungs clear to auscultation bilaterally. Hyperactive
bowel sounds noted x 4. Abdomen soft and nontender. Small
bruise noted on right hand. Client reports an increase in
urination and had one episode of incontinence. Family noticed
increased agitation and delusions.
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