Author Question: A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the ... (Read 72 times)

plus1 · **on:** Jul 23, 2018

A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the patient has a shuffling gait and mild tremors.

The nurse will ask the patient's provider about which course of action? a. Administering a direct dopamine anta-gonist
b. Giving an anticholinergic medication
c. Increasing the dose of the antipsychotic drug
d. Switching to a second-generation anti-psychotic drug

Question 2

A patient is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notes that the patient's abdomen is distended and firm, and hypoactive bowel sounds are present. The patient has not had a stool for 3 days.

The nurse will contact the provider, who will: a. order a bulk-forming laxative.
b. order extra fluids and fiber.
c. perform diagnostic tests.
d. prescribe a cathartic laxative.

succesfull · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

B
The patient is showing signs of parkinsonism, an extrapyramidal effect associated with antipsy-chotic medications. Anticholinergic medications are indicated. A direct dopamine antagonist would counter the effects of the antipsychotic and remove any beneficial effect it has. Increasing the dose of the antipsychotic medication would only worsen the extrapyramidal symptoms. A second-generation antipsychotic medication may be used if parkinsonism is severe, since the risk of parkinsonism is lower than with the FGAs. This patient is exhibiting mild symptoms, so this is not necessary at this point.

Answer to Question 2

C
Laxatives are contraindicated for patients with abdominal pain, nausea, cramps, or other symp-toms of abdominal disease or an acute surgical abdomen. Laxatives should not be used in pa-tients with obstruction or impaction. This patient shows signs of abdominal obstruction, and lax-atives could cause a bowel perforation secondary to increased peristalsis. A bulk-forming laxative is contraindicated. Patients with acute abdomens should be kept NPO pending diagnosis. A cathartic laxative is contraindicated.