A nurse is providing patient education for a patient just ...

[mspears3]

A nurse is providing patient education for a patient just starting therapy with an antipsychotic agent.
 
  The nurse teaches the patient about the extrapyramidal effects of antipsychotic drugs, and provides information about symptoms that may develop early in therapy. The patient demonstrates understanding when he identifies which of the following as early extrapyramidal symptoms?
  a. Mild spasms of the muscles of the tongue, face, neck, or back
  b. Pacing and squirming
  c. Involuntary upward deviation of the eyes
  d. Cramping that causes joint dislocation

Question 2

A nurse is caring for a patient who just started on an antipsychotic drug and begins to complain of severe muscle spasms of the tongue, face, and back.
 
  Based on these manifestations, which class of drugs should the nurse anticipate that the prescriber will order?
  a. Narcotic antagonist
  b. Anticholinergic agent
  c. Neuroleptic agent
  d. Tricyclic agent

[FergA]

Answer to Question 1

ANS: B
Akathisia is characterized by pacing and squirming, which are extrapyramidal symptoms brought on by an uncontrollable need to be in motion.
Mild spasms of the muscles of the tongue, face, neck, and back are not associated with acute dystonia; the symptoms would be severe.
Involuntary upward deviation of the eyes, also known as oculogyric crisis, is another symptom of acute dystonia, but it is not an early extrapyramidal symptom.
Cramping that causes joint dislocation is associated with opisthotonus, which is consistent with acute dystonia but is not an early extrapyramidal symptom.

Answer to Question 2

ANS: B
The patient shows clear evidence of extrapyramidal symptoms involving acute dystonia, such as severe spasms of the muscles of the tongue, face, neck, and back.
A narcotic antagonist is indicated only for a narcotic overdose.
A neuroleptic agent is not indicated in this situation.
A tricyclic antidepressant is not indicated in this situation.

[mspears3]

Thanks for the timely response, appreciate it

[Jossy]

Gracias!