Ch22. Psychotherapeutic Agents

A nurse should be able to differentiate between the typical and atypical antipsychotic. Which are classified as atypical antipsychotics? (Select all that apply.)

Aripiprazole (Abilify) Clozapine (Clozaril)

client is prescribed olanzapine for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of olanzapine, what should the nurse suspect is triggering the client's reported polyuria and polydipsia?

diabetes mellitus

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 female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be:

"The prescription dose is always started as low as possible and the refills are monitored to prevent abuse."

An African American male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the physician's office with signs of tardive dyskinesia, and his physician modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen?

"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in African Americans."

A nurse is caring for an obese client with no identified comorbidities. Which body mass index (BMI) would be required for the use of a prescribed anorexiant?

27

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication?

Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.

A nurse caring for a client taking a CNS stimulant should monitor the client for which side effects? (Select all that apply.)

Disorientation Dyspnea Urinary retention Headache

The school nurse is conducting a screening of kindergarten students. The nurse will assess the children for what characteristics of ADHD? (Select all that apply.)

Hyperactivity Impulsivity Short attention span

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

A child with attention deficit hyperactivity disorder has been receiving methylphenidate for several years. The prescriber has explained a plan to temporarily discontinue the drug. What rationale for this action should the nurse explain?

It needs to be determined if the child still has symptoms that require treatment.

A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason?

It reduces the likelihood of drug dependence or diversion.

Which drug would be indicated for the treatment of narcolepsy?

Modafinil

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 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

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.

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?

height and weight

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n):

increased risk for toxic effects of haloperidol therapy.

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

lip smacking

A person is seen wandering the streets and talking in an animated way to people who are not there. These behaviors support what mental health diagnosis?

psychosis

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.

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?

Improving

The main goal of therapy when using CNS stimulants is to:

relieve the symptoms for which they were prescribed.

A female client relates that she is taking Valium for a muscle relaxant and Provigil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include:

Provigil may decrease the effects of her contraceptive, and she may need to use other protection.

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?

Pt will take med as prescribed

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

Serotonin abnormalities are thought to be involved in the following disorders:

Mental depression and sleep disorders.

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 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

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

WBC count

The students are learning about medications to treat ADHD. The pharmacology instructor discusses the medication methylphenidate, used to treat attention deficit hyperactivity disorder. According to the instructor, methylphenidate is which?

a central CNS stimulant.

What is the central nervous system stimulant of choice to treat narcolepsy?

modafinil

The use of what would a nurse identify as placing a client receiving lithium therapy at increased risk for toxicity?

thiazide diuretic

Typical antipsychotics block dopamine receptors.

true

The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse's best response?

"ADHD usually starts in childhood and may persist through adulthood."

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

Antipsychotic