Pharmacology II Chpt. 22 Psychotherapeutic Agents 1-4

Tardive dyskinesia

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? Urinary frequency Central nervous system agitation Tardive dyskinesia Hypertension

The client denies severe depressive or manic episodes

A client's medication regimen includes lithium. What assessment finding would suggest a therapeutic effect? The client states that she now has purpose and direction in her life The client denies severe depressive or manic episodes The client denies audio or visual hallucinations The client refrains from aggressive or violent outbursts

Increase fiber intake.

A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement? Take diphenoxylate hydrochloride. Take metronidazole. Increase fiber intake. Take an over-the-counter (OTC) laxative daily.

Increased blood glucose

A diabetic patient being treated for obesity tells the nurse that the patient is having adverse effects from the drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which adverse effects would need the nurse's immediate attention? Decreased libido Increased blood glucose Dry eyes Jittery feeling

Fasting blood sugar Weight Cholesterol profile

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. Fasting blood sugar Blood type Weight Cholesterol profile Blood pressure

Diabetes mellitus

A client is prescribed risperidone for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of risperidone, what should the nurse suspect is triggering the client's reported polyuria and polydipsia? Urinary tract infection Diabetes mellitus Renal calculi Hyperthyroidism

Seizures Hyperreflexia Hypotension

A client has a serum lithium level of 2.2 mEq/L. The nurse should expect to assess what symptoms? Select all that apply. Full body rash Seizures Hyperreflexia Polyuria Hypotension Epistaxis

Antipsychotics do not improve memory loss and may further impair cognitive functioning.

A female client's physician orders a low-dose antipsychotic to manage her acute agitation. Her daughter states that her mother is improved but her cognitive functions are the same, if not worse, than last month. What is the best explanation for this development? Antipsychotics cause a gradual return of cognitive ability. Antipsychotics reduce memory loss. Antipsychotics increase the risk of long-term memory loss. Antipsychotics do not improve memory loss and may further impair cognitive functioning.

Modafinil Armodafinil Methylphenidate Dextroamphetamine

A nurse caring for a client with narcolepsy may administer which CNS stimulants? (Select all that apply.) Modafinil Armodafinil Methylphenidate Phentermine Dextroamphetamine

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

Antipsychotic drugs are contraindicated in clients with: liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease. kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain. nausea, severe hypotension, or intractable hiccups. peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure.

Gradually taper the dose of haloperidol.

In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsychotic, the care team should implement which intervention? Gradually taper the dose of haloperidol. Have a 2- to 3-week "drug holiday" between stopping the haloperidol and starting the atypical antipsychotic. Administer haloperidol and the atypical antipsychotic drug concurrently for 6 to 8 weeks. Arrange for weekly electroconvulsive therapy (ECT) during the time of transition.

Lamictal 25 mg po q day

Many bipolar patients quit taking their medications. Research has now indicated that what may be effective in the long-term prevention of recurrent psychosis? Gene therapy Lamictal 25 mg po q day Depot injections of anti-psychotic drugs Intense, one-on-one psychotherapy

Chlorpromazine

The client reports taking a phenothiazine antipsychotic. What medication does the nurse suspect the client has been prescribed? Theophylline Haloperidol Chlorpromazine Thiothixene

Tardive dyskinesias

The nurse is caring for a patient who is taking an oral neuroleptic medication. What would be important to include in the patient teaching? Bradycardia Tardive dyskinesias Urge incontinence Orthostatic hypotension

"Has your quality of life improved since being prescribed this medication?"

The nurse is reviewing the care plan for a client who has been prescribed a central nervous system (CNS) stimulant. What nursing assessment question addresses the main goal of therapy? "How would you describe your ability to concentrate since taking the medication?" "Has your quality of life improved since being prescribed this medication?" "Are you having any difficulty taking the drug as it was prescribed?" "Have you been sleeping better since starting the medication?"

stay in bed for the next half hour.

The nurse just administered chlorpromazine to a client by intramuscular injection. The nurse should instruct the client to: stay in bed for the next half hour. perform deep breathing and coughing exercises. report any new onset of chest pain promptly. expect urinary urgency for the next few hours.

Modafinil

What is the central nervous system stimulant of choice to treat narcolepsy? Atomoxetine Guarana Caffeine Modafinil

Respiratory pattern Respiratory rate Pulse Review recent lab work Blood pressure

What should the nurse's pre-administration assessment of a client receiving a CNS stimulant for respiratory depression include? (Select all that apply.) Respiratory pattern Respiratory rate Pulse Review recent lab work Blood pressure

Only a 1-week supply is dispensed at a time.

A client is prescribed clozapine. When developing the teaching plan for this client, the nurse would integrate knowledge of which of the following? WBC count has to be performed every month. The drug may cause urinary retention. Only a 1-week supply is dispensed at a time. Clozapine is a Pregnancy category C drug

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

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 come to the clinic regularly for blood tests." "I will need to stop taking my birth control pills while I take lithium." "My lithium dose may change depending on the results of my blood tests." "I will call the health care provider if I experience diarrhea."

Monitor fluid and sodium intake every 12 hours.

A female client 70 years of age is receiving lithium. Which nursing intervention is appropriate for this client? Instruct the client to use barrier contraceptives. Check blood glucose levels every six hours. Monitor fluid and sodium intake every 12 hours. Encourage the client to check daily for weight loss.

Regular complete blood counts

The nurse is providing education to a client who has been prescribed clozapine. The nurse should emphasize the importance of what monitoring routine during teaching? Weekly liver enzymes Daily international normalized ratio (INR) Monthly creatinine levels Regular complete blood counts

increased risk for toxic effects of haloperidol therapy.

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): decreased risk for toxic effects of haloperidol therapy. high drug efficacy of haloperidol. decreased risk for muscular contractions and spasms. increased risk for toxic effects of haloperidol therapy.

Risk for injury related to central nervous system depression

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 impaired liver function related to hepatotoxicity Bowel incontinence related to gastrointestinal adverse effects Risk for imbalanced body temperature related to hypothalamic suppression Risk for injury related to central nervous system depression

Inform the prescriber and monitor for GI and CNS effects

A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action? Inform the prescriber and perform a focused respiratory assessment Contact the prescriber and request a supplementary dose of lithium Inform the prescriber and monitor for GI and CNS effects Facilitate a transfer to the intensive care unit

Hyperactivity

A nurse who is providing care on a pediatric client has conducted a medication reconciliation. In light of the fact that the client takes methylphenidate, the nurse is justified in considering a history of what health problem? Anxiety Respiratory depression Obesity Hyperactivity

dopamine

A nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substance as being involved with this pleasurable feeling? epinephrine norepinephrine serotonin dopamine

Disorganized and often bizarre thinking

The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit? Slowed reaction time and poor coordination Disorganized and often bizarre thinking Short manic episodes followed by long depressive episodes Short- and long-term-memory deficits

Elevate blood pressure Cause wakefulness Nausea

The nursing student, in pharmacology class, is learning about amphetamines. The student identifies this class of drugs to have what actions? Select all that apply. Elevate blood pressure Cause wakefulness Decrease respiratory rate Nausea