The nurse is assessing a young adult patient with schizophrenia ...

[HudsonKB16]

The nurse is assessing a young adult patient with schizophrenia who recently began taking fluphenazine (Prolixin). The patient is exhibiting spasms of facial muscles along with grimacing, and the nurse notes upward eye movements.
 
  The nurse suspects which side effect?
  a. Acute dystonia
  b. Akathisia
  c. Pseudoparkinsonism
  d. Tardive dyskinesia

Question 2

A patient who takes loxapine (Loxitane) to treat schizophrenia is noted to be restless and fidgety and is pacing around the room. The nurse caring for this patient will perform which action?
 
  a. Contact the provider to discuss changing to benztropine (Cogentin).
  b. Notify the provider of these symptoms and request an order for lorazepam (Ativan).
  c. Question the patient about adherence to the drug regimen.
  d. Recognize these signs of a serious adverse drug reaction and notify the provider.

[djpooyouma]

Answer to Question 1

ANS: A
Acute dystonia can occur within days of taking typical antipsychotics, and facial muscle spasms, grimacing, and upward eye movements are characteristic of this side effect. Akathisia is characterized by restlessness, pacing, and difficulty standing still. Pseudoparkinsonism is characterized by stooped posture, pill-rolling, shuffling gait, and tremors at rest. Tardive dyskinesia manifests as protrusion and rolling of the tongue, smacking of the lips, and involuntary movement of the body and extremities.

Answer to Question 2

ANS: B
The patient is exhibiting signs of akathisia and should be treated with an antianxiety drug. Benztropine is an anticholinergic used to combat acute dystonia side effects. These are not signs of psychosis, so it is not necessary to question whether or not the patient is taking the medication. These side effects are not as serious as those with tardive dyskinesia.

[HudsonKB16]

Thank you!

[djpooyouma]

Always glad to help...