Chapter 56 Prep U- Pharm

A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis?

Risk for injury related to central nervous system depression

A 14 year-client with symptoms of psychosis has been prescribed pimozide 0.05 mg/kg PO at bedtime. The client weighs 154 lbs. How many mg of pimozide should the client be administered?

3.5 mg: 154/2.2= 70, 70x0.05

The health care provider prescribed antipsychotic medication for a female client 2 months ago. She is noncompliant with her medication regimen and is symptomatic. The nurse is responsible for developing a plan of care to facilitate medication compliance. What would the nurse include in this plan?

Coordination of the efforts of several health and social service agencies or providers

What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia?

Lip smacking

A 24-year-old client is being seen in the emergency department because of a high fever and cannot move the right arm. During the history-taking process, The nurse discovers the client is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client?

The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically thereafter?

white blood cell (WBC) count

For clients taking clozapine, it is necessary to monitor what lab test for the first 6 months?

White blood cells

A female client makes an appointment with her health care provider 2 weeks after beginning her prescription antipsychotic therapy. She states that she is still unable to cope and concentrate at work. What statement would be appropriate to include in the nurse's teaching?

"Antipsychotics may take several weeks to achieve maximum therapeutic effect."

A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation?

Antipsychotic

The nurse expects to monitor a client's white blood count weekly when the client is prescribed:

Clozapine

Which test should be scheduled every week for a patient taking clozapine?

WBC count

Antipsychotic drugs are contraindicated in clients with:

liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

After administration of haloperidol to an acutely dehydrated client, the nurse should prioritize what nursing assessment?

Blood pressure

The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis?

Disorganized and often bizarre thinking

For which adverse reactions should the nurse monitor the patient who has been administered antipsychotic drugs?

Dry mouth

A parenteral form of an antipsychotic is prescribed for a client who has become aggressive. When administering the drug, which site would be most appropriate for the nurse to use?

Gluteus

Parents bring a 15-year-old male into the clinic. The parents tell the nurse that there is a family history of schizophrenia and they fear their son has developed the disease. What is an appropriate question to ask the parents?

How long has your son been exhibiting symptoms?

When monitoring a client for possible neuroleptic malignant syndrome, the nurse will plan to implement what intervention into client care? Select all that apply.

Monitor for signs of respiratory distress. Document urinary output into client records every 8 hours. Assess temperature every 8 hours.

A client who is experiencing withdrawal from alcohol has developed psychosis and is being treated with haloperidol. Which assessment findings should prompt the care team to assess the client for neuroleptic malignant syndrome?

The client develops muscle rigidity and a sudden, high fever.

A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence?

The drug may need to be lowered in dosage or discontinued.

A client is being treated with clozapine. What should the nurse monitor most closely?

White blood count

A prescriber has written for olanzapine for a client diagnosed with schizophrenia. What additional tests should the nurse anticipate the prescriber to order? Select all that apply.

cholesterol profile weight Fasting blood sugar

A client's thought disorder has been treated with haloperidol. For what adverse effect should the nurse most closely monitor the client?

extrapyramidal effects

While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as:

tardive dyskinesia.

A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse?

"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

A male client's health care provider orders antipsychotic medications for him. He experiences little or no side effects from the medications and is able to function successfully in both his home and work environments. Six weeks later, he is diagnosed with hepatitis B. He begins to experience adverse reactions to his medications. A possible reason for the adverse reactions might be that, in the presence of liver disease, what may happen?

Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

A nurse is charting on a client who has repetitive tongue and jaw movements, and a facial tick. What term could the nurse use to document these findings?

Tardive dyskinesia

The client has been taking haloperidol for years and now has developed tardive dyskinesia. Which assessment findings would confirm this?

The client often smacks his lips and chews.

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital?

The patient will take medications as prescribed.