When a practitioner initiates therapy with a second-generation antipsychotic, which of the following is appropriate?

The appropriate action when initiating therapy with a second-generation antipsychotic is to record a baseline measurement of waist circumference. This is important because second-generation antipsychotics, such as olanzapine, risperidone, and quetiapine, are associated with metabolic side effects, including weight gain and changes in body fat distribution. Monitoring waist circumference can help identify central obesity, which is a significant risk factor for cardiovascular disease and metabolic syndrome.

By establishing a baseline waist circumference, the practitioner can track changes over time, assess the efficacy and safety of the treatment, and intervene early if adverse effects develop. This proactive approach is essential given the potential of these medications to contribute to increased body weight and metabolic complications.

While measuring blood pressure, liver function, and red blood cell count are important in different contexts, they are not the primary focus for monitoring when starting a second-generation antipsychotic. Blood pressure does need to be monitored for certain antipsychotics, but waist circumference is more directly related to the metabolic effects commonly seen with these medications. Liver function tests and red blood cell counts are typically not routinely required unless there are specific concerns regarding liver health or blood disorders.