Author Question: The nurse works on an inpatient mental health unit. When administering antipsychotic medications, ... (Read 33 times)

Beheh · **on:** Jul 23, 2018

The nurse works on an inpatient mental health unit. When administering antipsychotic medications, what patient would the nurse expect to require a standard dosage?

A) African American adolescent diagnosed with schizophrenia
B) Malaysian middle adult diagnosed with bipolar disorder
C) Iranian older adult diagnosed with schizophrenia
D) Caucasian young adult diagnosed with bipolar disorder

Question 2

While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug.

I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect? A) Cumulative effect
B) First-pass effect
C) Placebo effect
D) Cross-tolerance effect

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

Answer to Question 1

D
Feedback:
Only the Caucasian young adult has no indications for administering a smaller than usual dosage. African Americans respond more rapidly to antipsychotic medications and have a greater risk for development of disfiguring adverse effects, such as tardive dyskinesia. Consequently, these patients should be started off at the lowest possible dose and monitored closely. Patients in Asian countries (e.g., India, Turkey, Malaysia, China, Japan, Indonesia) receive lower doses of neuroleptics and lithium to achieve the same therapeutic response as seen in patients in the United States. Arab American patients metabolize antipsychotic medications more slowly than Asian Americans do and may require lower doses to achieve the same therapeutic effects as in Caucasians.

Answer to Question 2

C
Feedback:
A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.