Ch 56

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?

35

The wife of a client who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be which?

"Continue the prescribed dose. It may take several days to work."

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

white blood cell count

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

white blood cells

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 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."

The nurse is providing education to a client who has been prescribed an antipsychotic drug. Which statement suggests that the client understands the typical length of medication therapy?

"I may always have to take this medication."

A female client is diagnosed with Alzheimer-type dementia. She resides in a long-term care facility. The client's daughter asks the health care provider to prescribe an antipsychotic to control her mother's outbursts of anger and depression. The provider orders a psychiatric consultation for the client. The client's daughter asks, "Why doesn't the provider just order an antipsychotic?" What is the nurse's best response to this family member?

"Use of antipsychotic drugs exposes clients to adverse drug effects and does not resolve underlying problems."

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

In clients with acute psychosis, the treatment goal during the first week of treatment includes:

Decreasing the client's symptoms and normalizing the patterns of sleeping and eating.

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

The nurse provides medication teaching to a client prescribed clozapine as treatment for schizophrenia. Which instructions will the nurse emphasize with this client? Select all that apply.

Do not drive while taking this medication, obtain weekly blood tests, do not stop taking this medication

A 77-year-old patient with physiologic dementia has been admitted to the unit. Haloperidol has been ordered for this patient. What are some facts about haloperidol? (Select all that apply.)

It should not be used to control behavior with dementia, Its dosage needs to be lowered in the older adult population, It is classed as an anti-psychotic

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

Lip smacking

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.

Which drug would be indicated for the treatment of narcolepsy?

Modafinil

Antipsychotic drugs are contraindicated in clients with:

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

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 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.

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.

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

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

WBC count

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

extrapyramidal effects

A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia?

lack of interest in normal activities

A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior?

tardive dyskinesia

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 male client taking an antipsychotic medication calls the psychiatric clinic and tells the nurse he is stopping his medication. He states that he has taken it for a week and it doesn't work. What is the nurse's best response?

"Antipsychotic medications take 6 to 10 weeks to demonstrate an effect on the disorder."

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

The nurse is providing education to a client who has been prescribed clozapine. During teaching, the nurse should inform the client of the need for regular monitoring of what laboratory test during the initial months of therapy and periodically thereafter?

Complete blood count (CBC)

The nurse is preparing to give prescribed haloperidol to an acutely dehydrated client. After administration, the nurse should prioritize what nursing assessment?

blood pressure

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