Author Question: A client is prescribed fluphenazine (Prolixin) and is experiencing muscle spasms of the neck. The ... (Read 148 times)

tingc95 · **on:** Jul 23, 2018

A client is prescribed fluphenazine (Prolixin) and is experiencing muscle spasms of the neck. The client is grimacing and having difficulty speaking. Which action should the nurse take?

1. Call the health care provider and prepare to give chlorpromazine (Thorazine) IM.
2. Distract the client to confirm the client is not faking a muscle spasm.
3. Call the health care provider and prepare to give diphenhydramine (Benadryl).
4. Engage the client in open-ended conversation to find out why the client is having difficulty speaking.

Question 2

A client who was prescribed trifluoperazine (Stelazine) 2 days ago presents with muscle spasms of the tongue. The health care provider orders diphenhydramine (Benadryl) 50 mg IV. What is the rationale for this medication?

1. To decrease saliva and mucous secretions
2. To reverse the acute dystonia
3. To prevent anaphylaxis
4. To sedate the client

akpaschal · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: Chlorpromazine (Thorazine) is not used to treat dystonia.
Rationale 2: Muscle spasms are difficult to fake.
Rationale 3: Signs of acute dystonia associated with fluphenazine include severe muscle spasms of the back, neck, tongue, and face. It can be so severe as to cause laryngospasm. When treated with diphenhydramine (Benadryl), it can be reversed within minutes.
Rationale 4: The client is having difficulty speaking. This would not be an appropriate action.
Global Rationale: Signs of acute dystonia associated with fluphenazine include severe muscle spasms of the back, neck, tongue, and face. It can be so severe as to cause laryngospasm. When treated with diphenhydramine (Benadryl), it can be reversed within minutes. Chlorpromazine (Thorazine) is not used to treat dystonia. Muscle spasms are difficult to fake. The client is having difficulty speaking; therefore, engaging the client in a conversation would not be an appropriate action.

Answer to Question 2

Correct Answer: 2
Rationale 1: Decreasing secretions is not the reason for administering this medication to a client with dystonia.
Rationale 2: Diphenhydramine (Benadryl) is used to reverse the acute dystonia before the client has respiratory distress caused by laryngospasms.
Rationale 3: The client does not display symptoms of anaphylaxis.
Rationale 4: Sedation will not help the client with dystonia.
Global Rationale: Diphenhydramine (Benadryl) is used to reverse the acute dystonia before the client has respiratory distress caused by laryngospasms. Decreasing secretions is not the reason for administering this medication to a client with dystonia. The client does not display symptoms of anaphylaxis. Sedation will not help the client with dystonia.