What is the priority nursing action if NMS is suspected?

What is the priority nursing action if NMS is suspected?

• A. STOP the antipsychotic immediately
• B. Increase the dose of the antipsychotic
• C. Administer a benzodiazepine only
• D. Defer treatment until physician assessment

Answer: (A)

Stopping the antipsychotic immediately is the priority because suspected neuroleptic malignant syndrome is a life-threatening reaction to the drug. The first step is to remove the offending agent to halt progression of the dangerous signs—high fever, severe muscle rigidity, autonomic instability, and potential complications like rhabdomyolysis and kidney injury. After discontinuing the medication, you would support the patient with cooling, aggressive IV fluids, close vital sign and lab monitoring (e.g., CK levels), and notify the physician for orders such as specific antidotes (e.g., dantrolene or bromocriptine) and ongoing management. Increasing the drug dose would worsen the condition, giving a benzodiazepine alone does not treat the underlying problem, and waiting for physician assessment before acting delays critical care.

Stopping the antipsychotic immediately is the priority because suspected neuroleptic malignant syndrome is a life-threatening reaction to the drug. The first step is to remove the offending agent to halt progression of the dangerous signs—high fever, severe muscle rigidity, autonomic instability, and potential complications like rhabdomyolysis and kidney injury. After discontinuing the medication, you would support the patient with cooling, aggressive IV fluids, close vital sign and lab monitoring (e.g., CK levels), and notify the physician for orders such as specific antidotes (e.g., dantrolene or bromocriptine) and ongoing management. Increasing the drug dose would worsen the condition, giving a benzodiazepine alone does not treat the underlying problem, and waiting for physician assessment before acting delays critical care.