Author Question: An older man is taking aripiprazole (Abilify) for agitation. Which patient assessment is the nurse's ... (Read 59 times)

mpobi80 · **on:** Jul 11, 2018

An older man is taking aripiprazole (Abilify) for agitation. Which patient assessment is the nurse's priority to prevent catastrophic effects of the medication?

a. Oral and facial dyskinesia c. Muscle spasms of the face
b. Mask facies, shuf-fling gait d. Repetitive aimless walking

Question 2

The nurse prepares to discharge an older man who has heart failure and is in stable condition, when his wife states that she will avoid sexual activities with him because of his heart disease.

Which of the following factors should the nurse use in patient teaching about sexual activity for an older adult with heart failure? a. An older adult with heart failure should avoid sexual relations because of the de-mand it places on the heart.
b. Sexual relations and climbing six flights of stairs expend the same amount of energy.
c. Fear and lack of knowledge can cause older people to reduce their sexual activity unnecessarily.
d. Sexuality is a private matter between the older man and his wife.

stanleka1 · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

A
This individual is taking an atypical antipsychotic agent to control manic episodes of dementia. Although these agents are less likely to cause tardive dyskinesia (TD), the nurse monitors for the associated abnormal movements of TD including oral and facial dyskinesia, which is an impair-ment in the ability to execute voluntary facial movement. The nurse immediately reports this ef-fect to stop therapy and to prevent an irreversible condition. Mask facies, having a masklike ap-pearance, and shuffling gait are parkinsonian side effects of antipsychotic agents and can be im-proved with antiparkinsonian agents. Muscle spasms of the face, tongue, neck, and back are ad-verse effects of antipsychotic agents usually observed within the first 5 days of therapy. They are potential indicators of acute dystonia and can be improved with antiparkinsonian agents. Motor restlessness is an adverse effect of antipsychotic agents and is characteristic of akathisia.

Answer to Question 2

C
Sex is not restricted to young and healthy individuals; therefore the nurse provides the patient and his wife with information about safely resuming sexual intimacy. With appropriate cardiac rehabilitation, much of his capacity for exertion, such as sexual activity, can be restored. The energy expenditure for sexual activity varies; but, typically, it takes less energy than climbing six flights of stairs. The nurse must be prepared to discuss sexual issues with patients and seeks op-portunities for discussion about sexual health.