A nurse new to psychiatry asks her colleague why the newer ...

[asd123]

A nurse new to psychiatry asks her colleague why the newer antipsychotic medications do not cause as many EPSEs as do the conventional antipsychotic medications. Which response, if made by the nurse, is correct?
 
  1. The newer antipsychotics also have a muscle relaxing effect that masks the EPSEs.
  2. The newer antipsychotics do not impact dopamine.
  3. The newer antipsychotics only act in the lower extrapyramidal dopamine pathways.
  4. The newer antipsychotics have less affinity for dopamine receptors and also bind to serotonin receptors.

Question 2

A client with a long history of experiencing domestic violence tells the nurse, There is no way out for me, this situation will never change. What nursing diagnosis would be most appropriate?
 
  1. High Risk for Violence
  2. Self-Esteem Disturbance
  3. Alteration in Health Maintenance
  4. Powerlessness

[kjohnson]

Answer to Question 1

4
Rationale: The conventional antipsychotic medications have a greater affinity for the dopamine receptors, and occupancy of the dopamine receptors above 80 leads to EPSEs. The newer antipsychotic medications have less affinity for dopamine and some affinity for serotonin, both of which reduce the risk for EPSE. The newer antipsychotics do not have a muscle relaxing effect and must work in the higher dopamine pathways to be effective.

Answer to Question 2

4
Rationale: Powerlessness is indicated when the client feels an inability to change the pattern or to leave the situation. The victim may experience Health Maintenance problems because of the experienced domestic violence, however, this is not the primary diagnosis. Some victims will experience self-esteem issues, which are secondary to their feeling of having little or no control over their life. The client is not at high risk to express violence, but is rather at high risk to experience it.