PrepU Antipsychotic Drugs

A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine. The client has been taking the medication for more than 40 years. What adverse effect will the client most likely experience?

Tardive dyskinesia

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

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

WBC

A client is started on aripiprazole and the nurse notices the client is experiencing dry mouth and nasal congestion. What intervention does the nurse teach the client to minimize the side effects of the medication?

Drinking frequent sips of water

A man is brought into the emergency department and is screaming about the government spying on him and is talking to a wall. The nurse goes to take his pulse and he becomes violent. The nurse understands that the client reacts this way because of which reasons?

During a psychotic episode, clients do not perceive reality in the same way as others; therefore, touch may seem like a violent act.

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

Extrapyramidal effects

What client is being treated with a typical antipsychotic?

an agitated client who was given haloperidol during acute psychosis

The nurse should recognize what as the primary goal of treatment for haloperidol therapy?

decreased agitation and combativeness

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes.

What is the most important aspect of client teaching for a client diagnosed with schizophrenia who is being seen by a home care nurse?

maintaining medication regime

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?

reduced adverse effects

A client has been treated with chlorpromazine for many years. The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication?

tardive dyskinesia

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

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

During an intake assessment, the nurse notes that the client cannot sit still and continually stands up and walks around the room. The nurse knows that the term for this behavior is:

akathisia.

What medication is an example of a phenothiazine antipsychotic?

chlorpromazine

The nurse takes care of multiple clients on the unit who take antipsychotic medications. What are common nursing diagnoses for a client taking antipsychotic medications? Select all that apply.

Risk for Injury Risk for Impaired Physical Mobility Risk for Infection At Risk for Unstable Blood Glucose.

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

The nurse on the unit has several clients taking clozapine. For which client is clozapine, an antipsychotic, contraindicated?

The 45-year-old with bone marrow depression

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 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.

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.

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?

The client will remain safe.

What disease process is haloperidol used to treat?

Tourette's syndrome

A client's medication has been changed to clozapine. What assessment should the nurse perform to identify a life-threatening adverse effect early?

Vital signs monitoring

A client is prescribed clozapine (Clozaril). The client and family should be instructed on the adverse effects of this medication. What laboratory test is most important in the first 6 months of the medication regime?

Weekly WBC counts

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

White blood cells

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."

Which client statement reflects an understanding of typical length of antipsychotic medication therapy?

"I may always have to take this medication."

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction?

"I will need to stop taking my birth control pills while I take lithium."

A client has been admitted to the hospital following an acute schizophrenic episode. Which would be a priority question for the nurse to ask the client's family during the initial interview?

"What was the client doing or experiencing when the episode occurred?"

A client with schizophrenia has been prescribed 100 mg of thioridazine three times a day. Thioridazine is available as 25-mg tablets. How many tablets should the nurse administer the client in a single day?

12 tablets

When administering oral chlorpromazine, the nurse should implement which intervention?

Administer the drug 1 to 2 hours before bedtime.

A client has been prescribed clozapine, an atypical nonphenothiazine. Clients taking these drugs should be monitored for what life-threatening adverse effect?

Agranulocytosis

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

Antipsychotic

A 21-year-old client refuses to take his oral antipsychotic medication. What would be the appropriate action for the nurse do?

Attempt to reason with the client. If he still refuses, contact the provider for further instructions.

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

BP

A 17-year-old client has just been diagnosed with schizophrenia. When educating the family about the cause of this disease, the nurse should address what factors? Select all that apply.

Biochemical disruptions

A nurse is explaining to another nurse the difference between first-generation antipsychotics and second-generation antipsychotics. What is the biggest benefit of the second-generation antipsychotics?

Decreased extrapyramidal effects

When describing the action of conventional antipsychotic medications to a group of nursing students, which would the instructor address?

Inhibiting the release of dopamine in the brain

The nurse knows that which of the following is true about tardive dyskinesia?

It is irreversible.

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

Lip smacking

During health education with the nurse, what subject should be the primary focus for a client newly diagnosed with schizophrenia?

the importance of adherence to prescribed treatment

A client has been achieving an acceptable reduction in the positive and negative signs of schizophrenia after several weeks of treatment with clozapine. The client has asked the nurse if it is acceptable to have "a few drinks from time to time." How should the nurse best respond to the client's inquiry?

"When you're taking clozapine, it's best to avoid drinking alcohol altogether."

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

The nurse on a psychiatric unit contributes to the care of many clients, most of whom have physical as well as psychiatric health problems. For which client would clozapine most likely be contraindicated?

45-year-old with bone marrow suppression

A 12 year-old client has been prescribed thioridazine PO in three divided doses. The client weighs 110 lbs. The nurse consults the drug guide and confirms that this medication is approved for pediatric use at up to 3 mg/kg/d PO. What is this client's maximum safe individual dose?

50

The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit?

Disorganized and often bizarre thinking

A 28-year-old woman has been diagnosed with schizophrenia. The health care provider has prescribed a typical antipsychotic, haloperidol. Which will the nurse include in the teaching related to the most common adverse effects?

Extrapyramidal symptoms

The nurse is caring for a client who has been taking an oral neuroleptic medication for several years. What assessment should the nurse prioritize to best address the risk for adverse effects?

Monitoring the client for involuntary facial movements

A client is prescribed clozapine. The nurse suspects bone marrow suppression based on assessment of which of the following?

Mucous membrane ulceration

A nurse observing a client notices the client has developed muscle rigidity, altered mental status, tachycardia, and sweating. The nurse interprets these findings as suggesting which of the following?

Neuroleptic malignant syndrome (NMS)

The nurse has an order to give a client 10 mg PO of Abilify. The client cannot swallow pills. Which choices would be acceptable for the nurse to administer this medication?

Obtain the liquid form of the medication and have the client take 10 mg in liquid form.

A resident of a long-term care facility is experiencing insomnia since being transferred to the facility. What antipsychotic would best help this client sleep?

Questiapine

What behavior would cause the nurse to suspect a client is demonstrating an extrapyramidal effect (EPS) of antipsychotic drug therapy? Select all that apply.

inability to stay seated for any length of time repeated, involuntary twisting of the arms near-constant lip smacking

A client who has a diagnosis of schizophrenia is likely to have which pathophysiologic effect?

increased dopamine

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

Monitoring what laboratory test is most important in the first months of clozapine therapy?

regular complete blood counts

Chlorpromazine IM has been ordered for a client on the unit. The nurse caring for a client instructs the client to:

remain recumbent for at least 30 minutes after the injection.