Psychotic Disorders no. 4012

Psychotic Disorders no. 4012

QUESTION: A client is receiving haloperidol (Haldol) to reduce psychotic symptoms. As he watches television with other clients, the nurse notes that he has trouble sitting still. He seems restless, constantly moving his hands and feet and changing position. When the nurse asks what is wrong, he says he feels jittery. How should the nurse manage this situation?

✘O a.) Ask the client to sit still or leave the room because he is distracting the other clients.
✘O b.) Ask the client if he is nervous or anxious about something.
✓O c.) Give an as needed dose of a prescribed anticholinergic agent to control akathisia.
✘O d.) Administer an as needed dose of haloperidol to decrease agitation.

RATIONALE

RATIONALE: Akathisia, characterized by restlessness, is a common but often overlooked adverse reaction to haloperidol and other antipsychotic agents; it may be confused with psychotic agitation. To control akathisia, the nurse should give an as needed dose of a prescribed anticholinergic agent. The client can't control the movements, so asking him to sit still would be pointless. Asking him to leave the room wouldn't address the underlying cause of the problem. Encouraging him to talk about the symptoms wouldn't stop them from occurring. Giving more antipsychotic medication would worsen akathisia.
NURSING PROCESS STEP: Implementation
CLIENT NEEDS CATEGORY: Physiological integrity
CLIENT NEEDS SUBCATEGORY: Pharmacological and parenteral therapies
COGNITIVE LEVEL: Knowledge