For 2 weeks a patient has taken lithium (Lithane) and risperidone ...

[KimWrice]

For 2 weeks a patient has taken lithium (Lithane) and risperidone (Risperdal) daily for mani
 
  a. The patient now reports diarrhea, vomiting, and blurred vision. The nurse observes a coarse hand tremor. Select the nurse's priority action.
  a. Administer a PRN dose of benztropine (Cogentin) to relieve extrapyramidal symptoms (EPSEs).
  b. Hold the next dose of risperidone to prevent further drugdrug interaction.
  c. Reassure the patient that these side effects will decrease with time.
  d. Notify the prescribing physician immediately.

Question 2

A psychiatric facility is accredited by JCAHO. Which asset would be expected?
 
  a. A 4:1 patient-to-staff ratio
  b. Private rooms for all patients
  c. Use of a therapeutic milieu treatment model
  d. Telephones for private patient conversations

[mirabriestensky]

Answer to Question 1

D
The symptoms the patient is experiencing are consistent with a serum lithium level above the therapeutic level. The nurse should withhold the next dose, arrange for a stat serum lithium level determination, and notify the health care provider. Risperidone can be continued because this is not a drugdrug interaction problem. Administration of benztropine is inappropriate because these are not EPSE symptoms. Reassurance would be appropriate, but the patient should not be told that these symptoms will decrease with time and continued dosing.

Answer to Question 2

D
JCAHO environment-of-care standards stipulate that telephones must be available to allow patients to conduct private conversations. The other options are not specified in JCAHO standards.

[KimWrice]

Excellent

[dantucker]

TYSM