A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?
Shuffling walk
Suicidal ideation
Abnormal movements of the tongue and face
Oculogyric crisis
The Correct Answer is D
A. Shuffling walk. A shuffling walk is typically associated with parkinsonism or other movement disorders, which may occur with antipsychotic medications, but the specific symptom of restlessness more directly relates to other conditions.
B. Suicidal ideation. While monitoring for suicidal ideation is important in any client with psychosis, it is not specifically associated with the restlessness that the client reports in relation to chlorpromazine use.
C. Abnormal movements of the tongue and face. Abnormal movements of the tongue and face are more characteristic of tardive dyskinesia, which develops over a longer period of treatment. The acute restlessness the client is experiencing is more closely aligned with akathisia, a side effect of antipsychotic medications.
D. Oculogyric crisis. This condition involves involuntary upward eye movement and can occur as an acute dystonic reaction to antipsychotic medications like chlorpromazine. Given the client's report of restlessness, the nurse should monitor for this adverse effect, as it is more likely to manifest in the context of acute medication side effects.
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Related Questions
Correct Answer is C
Explanation
A. School-age. While some early signs of schizophrenia may appear in childhood, the diagnosis is generally not made during this age group. Schizophrenia typically manifests later, with more distinct symptoms.
B. Older adulthood. Schizophrenia is not commonly diagnosed in older adulthood. While some individuals may experience late-onset schizophrenia, the majority of cases are diagnosed earlier in life, typically in young adulthood.
C. Young adulthood. Schizophrenia is most commonly diagnosed in late adolescence to early adulthood, usually between the ages of 18 and 30. This age group is critical as the onset of symptoms tends to occur during this developmental period.
D. Preschooler. Schizophrenia is extremely rare in preschool-aged children. Diagnosing schizophrenia in this age group is challenging, as many of the behaviors associated with the disorder can overlap with typical developmental variations.
Correct Answer is D
Explanation
A. The importance of avoiding foods that contain tyramine when taking an antipsychotic. Tyramine restrictions apply to monoamine oxidase inhibitors (MAOIs), not antipsychotics like clozapine. MAOIs require dietary modifications to prevent hypertensive crises, but clozapine does not interact with tyramine-containing foods.
B. The importance of routine red blood cell count laboratory work when taking an antipsychotic. Clozapine requires regular white blood cell (WBC) and absolute neutrophil count (ANC) monitoring, not red blood cell counts, due to the risk of agranulocytosis, a potentially fatal condition that can lead to severe infections.
C. The importance of limiting fluid intake when taking an antipsychotic. Fluid restriction is not a standard recommendation for clozapine use. However, some antipsychotics can cause polydipsia (excessive thirst), which may lead to water intoxication, but fluid restriction is not a routine precaution.
D. The importance of medication adherence after the resolution of acute psychosis when taking an antipsychotic. Antipsychotic medications, including clozapine, require long-term adherence to prevent symptom relapse. Clients may feel better and stop taking their medication, increasing the risk of relapse into psychosis, so adherence education is crucial.
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