A patient receiving risperidone (Risperdal) reports severe muscle ...

[BrownTown3]

A patient receiving risperidone (Risperdal) reports severe muscle stiffness at 10:30 AM. By noon, the patient has difficulty swallowing and is drooling. By 4:00 PM, vital signs are body temperature, 102.8 F; pulse, 110 beats per minute;
 
  respirations, 26 breaths per minute; and blood pressure, 150/90 mm Hg. The patient is diaphoretic. Select the nurse's best analysis and action.
 
  a. Agranulocytosis. Institute reverse isolation.
  b. Tardive dyskinesia. Withhold the next dose of medication.
  c. Cholestatic jaundice. Begin a high-protein, high-cholesterol diet.
  d. Neuroleptic malignant syndrome. Immediately notify the health care provider.

Question 2

A patient with schizophrenia and auditory hallucinations anxiously tells the nurse, The voice is telling me to do things. Select the nurse's priority assessment question.
 
  a. How long has the voice been directing your behavior?
  b. Does what the voice tells you to do frighten you?
  c. Do you recognize the voice speaking to you?
  d. What is the voice telling you to do?

[catron30]

Answer to Question 1

ANS: D
Taking an antipsychotic medication coupled with the presence of extrapyramidal symptoms, such as severe muscle stiffness and difficulty swallowing, hyperpyrexia, and autonomic symptoms (pulse elevation), suggest neuroleptic malignant syndrome, a medical emergency. The symptoms given in this scenario are not consistent with the medical problems listed in the incorrect options.

Answer to Question 2

ANS: D
Learning what a command hallucination is telling the patient to do is important; the command often places the patient or others at risk for harm. Command hallucinations can be terrifying and may pose a psychiatric emergency. The incorrect questions are of lesser importance than identifying the command.

[BrownTown3]

Excellent

[lkanara2]

TYSM