Author Question: A client with a diagnosis of schizophrenia has stopped taking his prescribed olanzapine (Zyprexa) ... (Read 92 times)

gonzo233 · **on:** Jul 19, 2018

A client with a diagnosis of schizophrenia has stopped taking his prescribed olanzapine (Zyprexa) and gone on a cocaine and hallucinogen binge lasting several weeks.

When providing care for this client in the acute care setting after a cocaine-induced myocardial infarction, the nurse should recognize what?

A) He cannot resume treatment with psychotropic medications until he has tested negative for recreational drugs twice consecutively.
B) The pharmacokinetics of his prescribed medications may be affected by his recent substance use.
C) His olanzapine dosage will be temporarily increased in order to compensate for his missed doses over the past weeks.
D) He will have his medications administered intramuscularly rather than orally for the duration of his hospital stay.

Question 2

At the encouragement of his parents, a client with bipolar disorder and an addiction to methamphetamine has agreed to enter treatment.

Which of the following nursing activities takes place during the engagement phase of treatment for a client who has a dual diagnosis?

A) Establishing a therapeutic relationship
B) Stabilizing the client medically
C) Assisting the client in developing vocational skills
D) Initiating detoxification

cpetit11 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

Ans: B
The impact of alcohol and drugs of abuse may alter pharmacokinetics and exacerbate adverse effects when psychotropic medication is administered. Dosages are never increased to compensate for the past. IM administration would only be necessary if the client is noncompliant and legally incompetent, and medication would not be withheld until the client has had two consecutive negative drug screens.

Answer to Question 2

Ans: A
The engagement phase begins with the establishment of a therapeutic treatment relationship. Detoxification and medical stabilization are in the acute stabilization phase. The development of vocational skills takes place later in the rehabilitation and recovery phase.