A client receiving a first-generation antipsychotic develops symptoms of acute dystonia, including muscle spasms and neck stiffness. Which type of medication should the nurse anticipate administering to manage these side effects?
Selective serotonin reuptake inhibitors (SSRIs)
Beta-blockers
Diphenhydramine
Benzodiazepines
The Correct Answer is C
Choice A reason: SSRIs are antidepressants used to treat depression and anxiety disorders. They do not address extrapyramidal side effects like acute dystonia, so they would not be useful in this case.
Choice B reason: Beta-blockers are primarily used for cardiovascular conditions and akathisia (a sense of restlessness), but they are not the treatment of choice for acute dystonia.
Choice C reason: Diphenhydramine, an antihistamine with strong anticholinergic properties, is effective in treating acute dystonia by restoring the balance between dopamine and acetylcholine in the basal ganglia. This makes it the correct choice for managing the client’s symptoms.
Choice D reason: Benzodiazepines may help with agitation or anxiety, but they are not first-line treatment for acute dystonic reactions caused by antipsychotic medications.
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Related Questions
Correct Answer is A
Explanation
Choice A reason: This presentation is consistent with neuroleptic malignant syndrome (NMS), a rare but life-threatening reaction to antipsychotics characterized by severe muscle rigidity, hyperthermia, altered mental status, and autonomic dysfunction. Immediate discontinuation of the drug and emergency treatment are required.
Choice B reason: Restlessness and inability to sit still are signs of akathisia, an extrapyramidal side effect of antipsychotics. While distressing and requiring management, it is not life-threatening compared to NMS.
Choice C reason: A flat affect and reduced speech are negative symptoms of schizophrenia and may persist despite treatment. These are concerning for quality of life but do not require urgent medical intervention.
Choice D reason: Mild weight gain is a known side effect of many antipsychotics. It should be monitored and managed with lifestyle modifications but does not represent an immediate threat.
Correct Answer is B
Explanation
Choice A reason: Haloperidol may be used for severe agitation or hallucinations but is not the first-line treatment for delirium tremens because it does not address the underlying withdrawal process.
Choice B reason: Lorazepam, a benzodiazepine, is the drug of choice for managing alcohol withdrawal and delirium tremens. It reduces agitation, prevents seizures, and manages autonomic instability.
Choice C reason: Naltrexone is used to reduce alcohol cravings and prevent relapse but is not appropriate for acute withdrawal or delirium tremens.
Choice D reason: Disulfiram is an aversive therapy medication used to discourage alcohol consumption by causing unpleasant effects if alcohol is ingested. It is contraindicated during withdrawal due to safety risks.
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