A nurse is reviewing the medical histories of four clients.
Which of the following clients may develop extrapyramidal symptoms from medication therapy?
A client who has schizophrenia and is taking antipsychotic medication.
An older adult client who has pancreatitis and is taking enzymes.
An adult client who has type 2 diabetes mellitus and is taking insulin.
A client who is in the third trimester of pregnancy and taking iron supplements.
The Correct Answer is A
Choice A rationale:
Antipsychotic medications are a class of drugs commonly used to treat schizophrenia and other psychotic disorders. They work by blocking dopamine receptors in the brain. However, dopamine is also involved in motor control, and blocking its receptors can lead to extrapyramidal symptoms (EPS).
EPS are a group of movement disorders that can be caused by antipsychotic medications. They include: Akathisia: A feeling of restlessness and an inability to sit still.
Dystonia: Involuntary muscle contractions that can cause twisting or spasms.
Parkinsonism: Symptoms similar to Parkinson's disease, such as tremor, rigidity, and slowness of movement. Tardive dyskinesia: Involuntary, repetitive movements of the face, tongue, or other body parts.
The risk of developing EPS is higher with older antipsychotic medications, such as haloperidol and chlorpromazine. Newer antipsychotic medications, such as risperidone and olanzapine, are less likely to cause EPS, but they can still occur.
Clients who are taking antipsychotic medications should be monitored for EPS. If EPS develop, the medication may need to be changed or the dose reduced.
Choice B rationale:
Enzymes are not known to cause EPS. They are used to treat pancreatitis by helping the body to digest food.
Choice C rationale:
Insulin is not known to cause EPS. It is used to treat type 2 diabetes mellitus by helping the body to control blood sugar levels.
Choice D rationale:
Iron supplements are not known to cause EPS. They are often taken by pregnant women to prevent iron deficiency anemia.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale: Communicating empathy for the client’s feelings to increase rapport is an important aspect of nursing care. It helps in building a therapeutic relationship with the client, which can facilitate better communication and cooperation during treatment. However, while this is a valuable intervention, it does not take priority over monitoring for adverse effects of refeeding in a client diagnosed with anorexia nervosa who has begun to gain weight.
Choice B rationale: Helping the patient balance energy expenditure and caloric intake is a crucial part of the treatment plan for anorexia nervosa. This intervention aims to ensure that the client is receiving adequate nutrition for their body’s needs without excessive energy expenditure that could hinder weight gain. However, this intervention is not as immediate a priority as monitoring for refeeding syndrome, which can have severe and potentially life-threatening consequences.
Choice C rationale: Assessing for adverse effects of refeeding is the priority nursing intervention in this scenario. Refeeding syndrome is a serious and potentially life-threatening condition that can occur when nutritional replenishment is initiated in severely malnourished clients, such as those with anorexia nervosa. It is characterized by metabolic alterations, including hypophosphatemia, hypokalemia, and hypomagnesemia. These alterations can lead to serious complications, such as cardiac arrhythmias, respiratory failure, and neurological complications.
Therefore, early detection and management of refeeding syndrome are crucial.
Choice D rationale: Assessing for depression and anxiety during every shift assessment is an important part of psychiatric nursing care. Many individuals with anorexia nervosa also experience co-morbid psychiatric conditions, such as depression and anxiety disorders. Regular assessment can help detect any changes in the client’s mental status and prompt timely intervention. However, while this is an important aspect of care, it does not take priority over assessing for the adverse effects of refeeding.
Correct Answer is ["B","D","F"]
Explanation
Choice A rationale:
Personality disorders are not typically considered to be comorbidities of eating disorders. While some personality traits, such as perfectionism and obsessiveness, may be more common in individuals with eating disorders, these traits do not necessarily
constitute a personality disorder. Additionally, the presence of a personality disorder does not typically increase the risk of developing an eating disorder.
Choice B rationale:
Depression is one of the most common comorbidities associated with eating disorders. Studies have shown that up to 50% of individuals with eating disorders also experience depression. The relationship between eating disorders and depression is complex and bidirectional. Depression can contribute to the development of an eating disorder, and the behaviors associated with eating disorders can also worsen depression.
Choice C rationale:
Breathing-related sleep disorders, such as obstructive sleep apnea, are not typically associated with eating disorders. While some individuals with eating disorders may experience sleep disturbances, these disturbances are more likely to be related to other factors, such as anxiety or depression.
Choice D rationale:
Obsessive-compulsive disorder (OCD) is another common comorbidity of eating disorders. Studies have shown that up to 30% of individuals with eating disorders also have OCD. The symptoms of OCD, such as obsessive thoughts and compulsive behaviors, can overlap with the symptoms of eating disorders. For example, an individual with OCD may have obsessive thoughts about food and weight, and they may engage in compulsive behaviors related to eating, such as calorie counting or food restriction.
Choice E rationale:
Schizophrenia is not typically associated with eating disorders. While some individuals with schizophrenia may experience disturbances in eating behavior, these disturbances are more likely to be related to other symptoms of the disorder, such as delusions or hallucinations.
Choice F rationale:
Anxiety is another common comorbidity of eating disorders. Studies have shown that up to 60% of individuals with eating disorders also experience anxiety disorders. Anxiety can contribute to the development of an eating disorder, and the behaviors associated with eating disorders can also worsen anxiety.
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