A nurse provides teaching for a patient about to begin taking a ...

[jc611]

A nurse provides teaching for a patient about to begin taking a first-generation antipsychotic drug for schizophrenia. Which statement by the patient indicates a need for further teaching about side effects of these drugs?
 
  a. Anticholinergic effects are uncommon with this medication.
  b. I may experience gynecomastia and galactorrhea.
  c. I may feel lightheaded or dizzy and should sit or lie down if this occurs.
  d. Sedation may occur initially, but will subside in 1 to 2 weeks.

Question 2

A patient taking a first-generation antipsychotic (FGA) medication develops severe parkinsonism and is treated with amantadine (Symmetrel). The amantadine is withdrawn 2 months later, and the parkinsonism returns.
 
  The nurse will expect the provider to:
  a. give anticholinergic medications.
  b. make a diagnosis of idiopathic parkinsonism.
  c. resume the amantadine indefinitely.
  d. try a second-generation antipsychotic (SGA).

[jordangronback]

Answer to Question 1

ANS: A
Anticholinergic effects are common with FGAs, so this statement indicates a need for further teaching. Neuroendocrine effects, orthostatic hypertension, and sedation can occur with FGAs.

Answer to Question 2

ANS: D
Neuroleptic-induced parkinsonism is treated with some of the same drugs used for idiopathic parkinsonism, such as amantadine. If parkinsonism is severe, switching to an SGA may help, because the risk of parkinsonism is much lower with these drugs. An anticholinergic medication may be used initially. A recurrence of parkinsonism when the drug is withdrawn does not indicate idiopathic parkinsonism. These drugs should not be used indefinitely.

[jc611]

TYSM

[Sarahjh]

Thanks for the timely response, appreciate it