EAQ Antipsychotics

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Fresno City College *

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RN51

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Chemistry

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Dec 6, 2023

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pdf

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XPerformance Exit Week 10: ch 22 quiz # Due Oct 15, 2023 by 11:59 pm Passed 29 out of 37 questions answered correctly \/ Completed on Oct 15, 2023 7:14 pm Incorrect (8) A Which action would the nurse take when providing care to a patient who has recently been prescribed a benzodiazepine? () Assess sedation level. O Auscultate bowel sounds. (U) Check patient’s orientation. () Monitor the patient’s potassium levels.

Rationale Benzodiazepines are a class of anxiolytic medications that work by depressing the central nervous system (CNS). Therefore the nurse would assess the patient’s sedation level. Although these drugs are rapidly absorbed from the gastrointestinal tract, there is no evidence that they interfere with normal bowel function. Although these medications do depress the CNS, they often cause drowsiness and dizziness, not disorientation. Benzodiazepines do not affect electrolyte levels (e.g., potassium). p. 264 Which symptom does the nurse observe the patient for if the nurse is caring for a patient with acute dystonia during early treatment with typical antipsychotic agents? (U) Stooped posture () Inability to stand still () Protrusion of the tongue () Spasms of muscle groups Rationale Acute dystonia is an adverse extrapyramidal reaction that may occur during early treatment with typical antipsychotic agents. The patient develops spasms of the tongue, neck, face, and back. The back muscle spasms cause the trunk to arch forward. Thus the nurse would observe the patient for spasms of muscle groups. Pseudoparkinsonism, which is characterized by stooped posture, is a major side effect of typical antipsychotic drugs. The patient who develops akathisia is restless and unable to stand still. Tardive dyskinesia is a later extrapyramidal side effect, during which the patient may have protrusion and rolling of the tongue. b. 256

Which intervention is most important to ensure safety in a patient being treated with anxiolytic medications? (') Monitor for orthostatic hypotension. () Instruct the patient not to miss doses. (U) Teach the patient about the side effects. O Monitor the patient’s response to therapy. Rationale Anxiolytic drugs tend to affect the blood pressure, causing orthostatic hypotension, which can cause dizziness in the patient and increase the risk for falls. Therefore the nurse would monitor the blood pressure of the patient to prevent falls and ensure safety. The nurse should teach the patient about the side effects of the drugs; however, this can be done only when the patient is stabilized on the anxiolytics. The nurse would tell the patient not to miss any doses to ensure the maintenance of therapeutic levels of the drug, but this would be a secondary intervention. The nurse would monitor the patient’s response to the therapy, as this helps to assess cases in which the dose needs to be adjusted, but this would not help prevent falls in the patient. p. 266 Which instruction would the nurse provide to a patient who has been prescribed an oral phenothiazine? () “Expect to have cloudy urine while taking the medication.” (O) “Take an antacid 1 hour before or after taking the medication.” () “Avoid taking this drug and an antihypertensive simultaneously.” () “Take the medication on an empty stomach for quick absorption.” Rationale

The nurse would teach the patient to avoid taking an antihypertensive and an oral phenothiazine simultaneously, as the combination causes an additive hypotensive effect. Liver enzymes metabolize phenothiazines into phenothiazine metabolites; these cause the urine to appear pinkish or reddish-brown, not cloudy. Antacids decrease the absorption rate of oral phenothiazines; therefore the nurse would instruct the patient to take antacids either 1 hour before or 2 hours after taking the drug. Oral phenothiazines are absorbed rapidly and are not affected by food, so the patient would not need to take the drug on an empty stomach. p. 258 Which condition is considered the most serious potential reaction to antipsychotics? () Seizures () Acute dystonia (O) Tardive dyskinesia () Neuroleptic malignant syndrome Rationale Neuroleptic malignant syndrome is rare but potentially fatal, so it is considered the most serious potential reaction to antipsychotics. Acute dystonia and tardive dyskinesia are abnormal but not likely to cause death. Seizures are also serious, but the ability to control them makes them less serious. p. 256 Which condition would the nurse report to the primary health care provider upon observing a patient with a shuffling gait, a pill-rolling motion of the hands, and bradykinesia? () Akathisia () Acute dystonia

(O) Tardive dyskinesia () Pseudoparkinsonism Rationale A shuffling gait, a pill-rolling motion of the hands, and bradykinesia are symptoms of pseudoparkinsonism, so the nurse would report pseudoparkinsonism to the primary health care provider. Restlessness, constant back-and-forth motion of the feet, and trouble standing still are symptoms of akathisia. A patient with acute dystonia shows symptoms such as facial grimacing, involuntary upward eye movement, and laryngeal spasms. A person with tardive dyskinesia shows symptoms such as facial dyskinesia, protrusion and rolling of the tongue, and involuntary movements of the body and extremities. p. 255 Which intervention would be the nurse’s priority upon learning that a patient taking fluphenazine has a history of blood dyscrasias? () Administering oral doses with food or milk () Consulting with the primary health care provider () Staying with the patient until the medication is swallowed () Instructing the patient to quit smoking during the treatment Rationale The nurse would immediately consult with the primary health care provider regarding the medication, as fluphenazine is contraindicated for patients with blood dyscrasias. A life-threatening adverse effect of the medication is agranulocytosis. Oral doses of antipsychotic drugs should be given with food or milk to prevent gastric irritation. Ensuring that the patient swallows the medication helps in maintaining dosage accuracy. It is essential to quit smoking because smoking enhances the metabolism rates of some antipsychotics. However, these interventions are not appropriate in this

situation because fluphenazine should not be prescribed to patients with blood dyscrasias. Test-Taking Tip: Read the question carefully before looking at the answers. First, determine what the question is really asking; look for keywords. Second, read each answer thoroughly and see if it completely covers the material asked by the question. Third, narrow the choices by immediately eliminating answers that you know are incorrect. p. 258

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