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?

Administer the medication at bedtime. Signup and view all the answers

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

I have only met Jenny twice, but I know she loves me. Signup and view all the answers

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

Neologism Signup and view all the answers

What is considered a therapeutic lithium level?

1.2 mEq/L Signup and view all the answers

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

You will slowly be exposed to increasing levels of public spaces. Signup and view all the answers

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

Difficulty sleeping for several weeks Signup and view all the answers

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

If you aren't able to sleep, you can get out of bed and read a book. 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?

Akathisia Signup and view all the answers

What is donepezil used for?

Alzheimer's disease. Signup and view all the answers

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

Take at bedtime. Signup and view all the answers

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

Hypervigilance Signup and view all the answers

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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Description

This quiz explores the side effects of antipsychotic medications, particularly extrapyramidal symptoms such as akathisia, dystonia, and tardive dyskinesia. It also addresses delusional thinking in psychotic disorders and effective care strategies for clients with Alzheimer's Disease. Test your knowledge on these critical aspects of psychiatric nursing.