A client in the emergency department tells the nurse about being ...

[skymedlock]

A client in the emergency department tells the nurse about being chased by a serial killer. The client is currently paranoid and is aggressively fighting against any treatment.
 
  Which medication does the nurse anticipate will be prescribed for this client?
  1. Clozapine (Clozaril) in intramuscular (IM) form
  2. Risperidone (Risperdal) IM
  3. Loxapine (Loxitane) IM
  4. Lorazepam (Ativan) IM

Question 2

A client was prescribed olanzapine (Zyprexa) four weeks ago to treat symptoms of schizophrenia. The client's family has noted only a small improvement in symptoms and asks about changing to another treatment.
 
  Which response by the nurse is the most appropriate?
  1. The client will need to see a psychotherapist in conjunction with the medication for there to be a major improvement in symptoms.
  2. It might take 68 weeks to see definite improvement in most symptoms.
  3. It might take 812 weeks to begin seeing improvement on this therapy.
  4. There should have been improvement within 12 weeks.

[Eunice618]

Answer to Question 1

Correct Answer: 4
Rationale 1: Clozaril is given only by mouth and if there is no response to safer drugs.
Rationale 2: The intramuscular form of risperidone takes three weeks to produce a therapeutic response.
Rationale 3: Even though Loxitane may be given intramuscularly, it is restricted to treating mental illness refractory to treatment with safer drugs.
Rationale 4: Benzodiazepines such as Ativan may be administered intramuscularly during the initial treatment period; they provide sedation for agitated clients.
Global Rationale: Benzodiazepines such as Ativan may be administered intramuscularly during the initial treatment period; they provide sedation for agitated clients. Clozaril is given only by mouth and if there is no response to safer drugs. The intramuscular form of risperidone takes three weeks to produce a therapeutic response. Even though Loxitane may be given intramuscularly, it is restricted to treating mental illness refractory to treatment with safer drugs.

Answer to Question 2

Correct Answer: 2
Rationale 1: Psychotherapy is an essential component of treatment for clients with psychosis to return to society, but this is not the best answer. There should be a major improvement in symptoms with medication alone.
Rationale 2: By 68 weeks, definite improvement should be noted in most symptoms.
Rationale 3: After 812 weeks of therapy, if there has not been substantial improvement, the health care provider will need to explore reasons for lack of response and might need to change the medication.
Rationale 4: After 24 weeks (not 12 weeks), there is usually improvement in mood, socialization, and ability to provide self-care.
Global Rationale: By 68 weeks, definite improvement should be noted in most symptoms. Psychotherapy is an essential component of treatment for clients with psychosis to return to society, but this is not the best answer. There should be a major improvement in symptoms with medication alone. After 812 weeks of therapy, if there has not been substantial improvement, the health care provider will need to explore reasons for lack of response and might need to change the medication. After 24 weeks (not 12 weeks), there is usually improvement in mood, socialization, and ability to provide self-care.

[skymedlock]

Thank you!

[Eunice618]

Always glad to help...