A client diagnosed with schizophrenia, who has been taking antipsychotic medication for the last 5 months, presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?

A. Neuroleptic malignant syndrome, treated by discontinuing antipsychotic medications: The symptoms described (uncontrollable tongue movements, stiff neck, difficulty swallowing) are more indicative of tardive dyskinesia than neuroleptic malignant syndrome. Neuroleptic malignant syndrome is characterized by hyperthermia, autonomic dysregulation, altered mental status, and generalized muscle rigidity. Treatment involves discontinuing antipsychotic medications and supportive care.

B. Agranulocytosis treated by administration of clozapine (Clozaril): Agranulocytosis is a rare but serious side effect of clozapine, not a treatment for the symptoms described. The symptoms presented are more consistent with tardive dyskinesia.

C. Tardive dyskinesia treated by discontinuing antipsychotic medication: This is the correct answer. Tardive dyskinesia is a movement disorder characterized by involuntary and abnormal movements, including tongue protrusion and facial grimacing. It can result from long-term use of antipsychotic medications, and discontinuing or reducing the dose of the antipsychotic is a primary intervention.

D. Headache treated by administration of Hydrochlorothiazide: Hydrochlorothiazide is a diuretic used to treat conditions like high blood pressure and edema, not headache or the symptoms described, which are more indicative of tardive dyskinesia.

A. Case Manager:

A case manager is typically responsible for coordinating and managing the overall care and services for a client. This role involves collaboration with various healthcare professionals and services outside the immediate treatment setting.

B. Educator:

An educator is involved in providing information, teaching, and promoting the understanding of health-related topics. While education is an essential component of nursing care, the described actions are more indicative of another role.

C. Counselor:

A counselor focuses on providing emotional support, guidance, and therapeutic communication to help clients explore and address personal issues. While nurses do engage in counseling, the described actions emphasize a broader role.

D. Milieu Manager:

The role of a milieu manager involves organizing and maintaining the therapeutic environment, including scheduling activities, managing interactions, and ensuring safety on a psychiatric unit. This role is crucial for creating a supportive and therapeutic atmosphere for clients.