A client on clozapine reports lethargy and myalgia. What should the nurse do next?

Clozapine is an atypical antipsychotic medication associated with a risk of agranulocytosis, a potentially dangerous decrease in white blood cell count. When a patient reports symptoms such as lethargy and myalgia, it is critical to assess their white blood cell counts to rule out any hematologic side effects from the medication.

Obtaining a complete blood count (CBC) along with the absolute neutrophil count (ANC) helps determine if there is an underlying issue, especially concerning the immune response. A significant drop in white blood cells can lead to increased susceptibility to infections, which can manifest as nonspecific symptoms like lethargy and muscle pain.

In contrast, infusing a saline bolus, scheduling an electroencephalogram, or placing the client on a tyramine-free diet does not directly address the potential hematologic complications associated with clozapine. A saline bolus may temporarily address dehydration or electrolyte imbalances, an EEG focuses on neurological activity unrelated to clozapine's side effects, and a tyramine-free diet is relevant to monoamine oxidase inhibitors rather than clozapine. Thus, confirming the client’s white blood cell count is the most appropriate next step in this scenario to ensure