A nurse is caring for a client in the emergency department (ED).

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

C. Tardive dyskinesia is a movement disorder characterized by repetitive, involuntary movements of the face, tongue, and sometimes other parts of the body. These movements can include lip smacking, tongue protrusion, grimacing, and rapid eye blinking. Tardive dyskinesia is a well-known adverse effect associated with long-term use of antipsychotic medications, particularly first- generation antipsychotics such as chlorpromazine.
A. Neuroleptic Malignant Syndrome is a rare but serious adverse reaction to antipsychotic medications, characterized by symptoms such as severe muscle rigidity, high fever, altered mental status (e.g., confusion), autonomic instability (e.g., fluctuations in blood pressure, heart rate), and elevated creatine phosphokinase (CPK) levels.
B. Dysthymia is a chronic mood disorder characterized by persistent feelings of sadness, hopelessness, and low self-esteem. Dysthymia is not directly related to the involuntary movements described in the scenario and is unlikely to be the cause of the client's symptoms.
D. Akathisia is a movement disorder characterized by inner restlessness and the inability to sit still. Akathisia is a common side effect of antipsychotic medications and can be distressing for affected individuals. However, the symptoms described in the scenario, specifically involuntary movements of the tongue and face, are more indicative of tardive dyskinesia rather than akathisia.

D. By offering assistance with getting ready and framing participation in activities as a manageable task, the nurse can help the client overcome feelings of inertia and initiate engagement. It acknowledges the client's current difficulties while providing gentle encouragement to participate in the unit's programs.

A. This response may come across as dismissive of the client's feelings and struggles. It may also increase feelings of guilt or inadequacy in the client, potentially worsening their depressive symptoms.

B. It offers support without pressure and allows the client to take the initiative when they feel comfortable to engage in activities. However, it may not provide enough encouragement or assistance for the client to overcome their depressive symptoms and initiate activity.

C. Encouraging prolonged withdrawal from activities without offering support or motivation to engage may contribute to further isolation and exacerbate depressive symptoms.