Nokea
The caregiver of a client who is started on antipsychotic drug therapy asks the nurse when the client's symptoms will improve. Which response by the nurse would be most appropriate?
- A. You should notice an improvement in the next day or two.'
- B. It might take about 6 weeks or so before the drug is most effective.'
- C. There's no way to tell but usually it takes about a week.'
- D. Look for movements of his face, mouth, or jaw and that's the sign.'
Correct Answer: B
Rationale: Antipsychotics take time to produce the optimal effect, sometimes 6 to 10 weeks. Evidence of tongue, facial, or mouth movements suggest tardive dyskinesia, a late-appearing reaction that requires discontinuation of the drug.
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Which of the following are reasons a nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally? Select all that apply.
- A. Client is combative.
- B. Client refuses the medication.
- C. Client won't allow the nurse to inspect the oral cavity.
- D. Client has difficulty swallowing.
- E. Client is elderly.
Correct Answer: A,B,C
Rationale: A nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally because the client is combative, refuses the medication, or refuses to allow the nurse to inspect the oral cavity. Clients who have difficulty swallowing may be given an oral liquid in lieu of an IM injection.
Antipsychotic therapy with a conventional antipsychotic has been started for a client with schizophrenia. Assessment reveals that the client is experiencing drowsiness that is affecting his ability to function. The nurse notes that the client needs assistance with his activities of daily living and ambulating. Which nursing diagnosis would the nurse most likely identify?
- A. Risk for Infection
- B. Risk for Unstable Blood Glucose Level
- C. Risk for Injury
- D. Impaired Physical Mobility
Correct Answer: C
Rationale: Antipsychotic drugs may cause extreme drowsiness and sedation, especially during the first or second weeks of therapy. This reaction may impair mental or physical abilities. The patient may need assistance with activities of daily living due to the experience of extreme sedation. This includes cueing or help with eating, dressing, and ambulating. Therefore, Risk for Injury would be most appropriate. Risk for Infection would be appropriate if the client was receiving clozapine. Risk for Unstable Blood Glucose Level would be appropriate if the client was receiving an atypical antipsychotic due to the increased risk for weight gain and subsequent development of diabetes. Impaired Physical Mobility would be appropriate if the client was experiencing EPS or TD.
A nurse is required to administer an antipsychotic agent parenterally. After administering the drug, the nurse would ensure that the client remains lying down for which time frame?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: B
Rationale: After administering an antipsychotic agent parenterally, the nurse would ensure that the client remains lying down for about 30 minutes.
When teaching a client who is to receive antipsychotic therapy, the nurse would include which of the following as a common skin reaction that might occur when initiating therapy? Select all that apply.
- A. Urticaria
- B. Stevens-Johnson syndrome
- C. Photosensitivity
- D. Hyperpigmentation
- E. Toxic epidermal necrolysis
Correct Answer: A,C
Rationale: Urticaria and photosensitivity are common skin reactions a nurse should warn a client about when the client is initiated on antipsychotic therapy.
When assessing a client receiving antipsychotic drugs, the nurse would suspect that the client is experiencing extrapyramidal syndrome (EPS) based on assessment of which of the following? Select all that apply.
- A. Fine tremor
- B. Hypotension
- C. Akathisia
- D. Anhedonia
- E. Dystonia
Correct Answer: A,C,E
Rationale: The signs of EPS include fine tremors, muscle rigidity, mask-like appearance of the face, slowness of movement, slurred speech, unsteady gait, akathisia, and dystonia. Anhedonia is a manifestation of schizophrenia.