Question

A client is newly diagnosed with schizophrenia and will be treated with a first generation anti-psychotic. The nurse knows this client is at risk for extrapyramidal effects (EPS).

1. Discuss the assessments and potential plan of care for EPS.

Answer 1

Extrapyramidal symptoms as a disorder of parkinsonism, acute dystonia and acute akathisia with side effects in the early onset. The first episode of psychosis due to second-generation antipsychotics makes advantages on first-generation drugs that lead to extrapyramidal effects. the nurse should assess the patient for symptoms of dystonia like spasm and muscle contraction, akathisia like motor restlessness and rigidity as parkinsonism character, slowness of movement, jerky movement, tremor, etc.
plan of care:
-Advice the patient and family about acute dystonic reaction and the use of self-administration of diphenhydramine symptoms will resolve in minutes. it can be repeated if the symptoms not response within 30mintues.
-antipsychotic treatment required by administering antipsychotic and anticholinergic medications.
-Get neurologist opinion
-Tapper the medication of SSRI and valproic acid to help slow the symptoms.
-anticholinergic medications clonazepam is recommended
-Consider clozapine for tardive dyskinesia
-continue antipsychotic therapy
-Slowly tapper the antipsychotic medication and observe the symptoms for resolve.
-The extrapyramidal symptoms rating scale will be helpful to assess the type of drug-induced movement disorder.