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NURS 431 - Exam 2 Questions and Answers
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NURS 431 - Exam 2 Questions and Answers
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NURS 431 - Exam 2 Questions andAnswers
EPS - Answer-Imbalance dopamine & acetylcholine
- Parkinsonism: appearance of Parkinson's & tends to occur in OA, muscle rigidity
- Dystonic reactions: develops rapidly, muscle tense, body contortion
-- oculogyric crisis: eyeballs look toward ceiling
-- torticollis: neck muscles pull head to side
-- retrocollis: head pulled back
-- orolaryngeal-pharyngeal hypertonus: extreme difficulty swallowing
EPS Dystonic reactions tx - Answer-- Tx: benzotropine (Cogentin) or diphenhydramine
(Benadryl) IM or IV, then daily anticholinergic, maybe decrease antipsychotic dose
EPS Parkinsonism tx - Answer-- Tx: decrease antipsychotic dosage or add
anticholinergic drug (benzotropine (Cogentin), trihexyphenidyl (Artane))
Akathisia - Answer-caused by same mechanism as the EPS
- restless, feel driven to keep moving, very uncomfortable
- often misinterpreted as anxiety or increased psychotic symptoms
Tardive dyskinesia - Answer-- late-appearing abnormal involuntary movements, can be
viewed as opposite of parkinsonism, constant movement
- typical movements of mouth, tongue, & jaw and include lip smacking, sucking,
puckering, tongue protrusion, bonbon sign (tongue rolls around mouth & protrudes into
cheek), athetoid (worm-like) movements in tongue, and chewing
- movements of trunk & limbs: rocking from hips, athetoid movements of fingers & toes,
guitar strumming movements,
Nursing Interventions for Anticholinergic SE - Answer-- dry mouth: provide sips of water,
hard candies, and sugar-free chewing gum
- blurred vision: avoid dangerous tasks; teach pt that this SE will diminish in a few
weeks
- decreased lacrimation: use artificial tears if necessary
- mydriasis: may aggravate glaucoma; teach to report eye pain
- photophobia: wear sunglasses
- constipation: high-fiber diet, increased fluid intake, laxatives as prescribed
- urinary hesitancy: privacy, run water in sink, warm water over perineum
- urinary retention: regular voiding (at least q2-3h) and whenever urge is present, cath
for residual, record I&O, evaluate for BPH
- tachycardia: eval for preexisting CV disease, sudden death has occurred w/
thioridazine (Mellaril)
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