Psychiatric Nursing: Antipsychotics & Delusions

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Questions and Answers

Which of the following extrapyramidal side effects is the client likely experiencing?

  • Dystonia
  • Akathisia (correct)
  • Tardive dyskinesia
  • Parkinsonism

Which response should the nurse offer to the client experiencing auditory delusions?

  • Why do you think the TV is a 2-way radio?
  • That must be very frightening. (correct)
  • What we say is not being recorded.
  • Let's ignore the voice and talk about something else.

What action should the nurse take for a client with Alzheimer's who is agitated during morning care?

  • Obtain assistance to restrain the client for safety.
  • Firmly state to the client that morning care will be performed.
  • Call the provider to request an Rx for antipsychotic medication.
  • Talk to the client from 2 arm-lengths away. (correct)

Which of the following actions should the nurse take for a client on donepezil?

<p>Administer the medication at bedtime. (C)</p> Signup and view all the answers

Which statement by the client should the nurse recognize as an erotomaniac delusion?

<p>I have only met Jenny twice, but I know she loves me. (A)</p> Signup and view all the answers

The statement 'I need to get my gummamoshu from by my house' indicates which type of speech disturbance?

<p>Neologism (A)</p> Signup and view all the answers

What is considered a therapeutic lithium level?

<p>1.2 mEq/L (C)</p> Signup and view all the answers

Which comment should the nurse include in the teaching about systematic desensitization for a client with agoraphobia?

<p>You will slowly be exposed to increasing levels of public spaces. (D)</p> Signup and view all the answers

Which finding should the nurse expect from a client with major depressive disorder?

<p>Difficulty sleeping for several weeks (A), Absence of bathing for several days (B), Inability to concentrate on simple tasks (C), Lack of enjoyment from a lifetime hobby of gardening (E)</p> Signup and view all the answers

Which statement should the nurse make to a client with insomnia?

<p>If you aren't able to sleep, you can get out of bed and read a book. (D)</p> Signup and view all the answers

What is the adverse effect if a client reports feelings of inner restlessness after starting a first-generation antipsychotic medication?

<p>Akathisia (B)</p> Signup and view all the answers

What is donepezil used for?

<p>Alzheimer's disease.</p> Signup and view all the answers

What memory trick can help remember donepezil's administration time?

<p>Take at bedtime.</p> Signup and view all the answers

What finding should the nurse expect in a client with cocaine intoxication?

<p>Hypervigilance (B)</p> Signup and view all the answers

Flashcards

Akathisia

An intense feeling of inner restlessness, often experienced by individuals taking first-generation antipsychotics like haloperidol.

Extrapyramidal Side Effects

A group of side effects caused by antipsychotic medications, affecting movement and coordination. These include akathisia, dystonia, Parkinsonism, and tardive dyskinesia.

Delusion

A false belief that is firmly held despite evidence to the contrary. Often seen in individuals with psychotic disorders.

Erotomanic Delusion

A type of delusion where the individual believes someone, often a celebrity or someone they know, is in love with them. Example: "I've only met Jenny twice, but I know she loves me."

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Persecutory Delusion

A type of delusion where the individual believes they are being harmed or targeted by someone. Example: "My coworker is trying to poison me."

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Donepezil

A medication prescribed for Alzheimer's disease that helps preserve acetylcholine, a neurotransmitter important for memory and cognitive function.

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Neologism

A type of speech disturbance characterized by the creation of new words without meaning to others. Example: "I need to get my gummamoshu."

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Therapeutic Lithium Level

The ideal blood level of lithium for therapeutic effect. It typically ranges around 1.2 mEq/L.

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Systematic Desensitization

A technique used to treat agoraphobia by gradually exposing the individual to anxiety-inducing situations in a controlled manner, starting with less intense stimuli and gradually progressing to more challenging ones.

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Major Depressive Disorder (MDD)

A mood disorder characterized by persistent sadness, loss of interest, and other symptoms like difficulty sleeping, lack of concentration, and lack of personal care.

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Akathisia (Side Effect)

A common side effect of first-generation antipsychotics that presents as inner restlessness and the compelling urge to move. It usually arises within weeks of starting medication.

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Propranolol

A medication that can sometimes help reduce symptoms of akathisia, which is an extrapyramidal side effect of antipsychotics.

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Cocaine Intoxication

A state characterized by hypervigilance, paranoia, and dilated pupils. It usually occurs when someone is under the influence of cocaine.

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Study Notes

Extrapyramidal Side Effects of Antipsychotics

  • Akathisia is characterized by an intense feeling of inner restlessness, often seen in clients taking first-generation antipsychotics like haloperidol.
  • Other extrapyramidal side effects include dystonia, Parkinsonism, and tardive dyskinesia; each presents differently.

Delusional Thinking in Psychotic Disorders

  • Clients may present with various delusions; empathetic responses are crucial for building rapport.
  • Examples of delusions include:
    • Erotomanic delusions: Belief that someone has romantic feelings, e.g., "I have only met Jenny twice, but I know she loves me."
    • Persecutory delusions: Belief of being targeted or harmed, e.g., "My coworker is trying to poison me."

Care for Clients with Alzheimer’s Disease

  • Establish personal space when communicating with agitated clients; maintain a distance of 1-2 arm's lengths.
  • Donepezil is a cholinesterase inhibitor prescribed for Alzheimer's; it should be taken at bedtime to minimize bradycardia risk, and dosages should be gradually increased.

Signs and Symptoms of Schizophrenia

  • Neologism refers to the creation of new words without meaning to others, e.g., "I need to get my gummamoshu."
  • Other common disturbances include flight of ideas, echolalia, and perseveration.

Therapeutic Levels and Monitoring for Medications

  • Therapeutic lithium level typically ranges around 1.2 mEq/L; excess fluid intake and adequate sodium are essential to prevent toxicity.
  • Clients prescribed lithium must be monitored regularly for levels, especially after dosage adjustments.

Systematic Desensitization Technique for Agoraphobia

  • Clients with agoraphobia can benefit from gradual exposure to anxiety-inducing situations.
  • Systematic desensitization involves slowly exposing clients to increasing levels of public spaces to lessen their anxiety.

Major Depressive Disorder (MDD) Symptoms

  • Symptoms include:
    • Difficulty sleeping and inability to concentrate.
    • Lack of personal care (e.g., absence of bathing) and diminished interest in previously enjoyed activities (e.g., gardening).
  • Increased sexual desire is not typically associated with depression.

Insomnia Management Techniques

  • If unable to sleep, clients should get out of bed and engage in quiet activities like reading.
  • Napping should be limited to brief periods to enhance nighttime sleep quality; avoid electronics before sleep.

Adverse Effects of Antipsychotic Medications

  • Akathisia is a common side effect of first-generation antipsychotics that can arise within weeks; it is important to report such symptoms to a healthcare provider.
  • Propranolol may help alleviate symptoms of akathisia.

Cocaine Intoxication Indicators

  • Hypervigilance and paranoid behavior are common in clients experiencing cocaine intoxication; dilated pupils are characteristic.
  • Symptoms like drowsiness and nystagmus are not associated with cocaine use, with nystagmus more relevant to PCP intoxication.

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