Psychiatric Assessment and Fundamentals Q 46
Mario is admitted to the emergency room with drug-included anxiety related to over ingestion of prescribed antipsychotic medication. The most important piece of information the nurse in charge should obtain initially is the:
A. Length of time on the med.
B. Name of the ingested medication & the amount ingested.
C. Reason for the suicide attempt.
D. Name of the nearest relative & their phone number.
Correct Answer: B. Name of the ingested medication & the amount ingested.
In an emergency, lives saving facts are obtained first. The name and the amount of medication ingested are of utmost important in treating this potentially life-threatening situation. Second-generation antipsychotics carry the FDA boxed warning of increased incidence of stroke in elderly patients with dementia. The recommendation is to avoid the use of second-generation antipsychotics along with other drugs that prolong the QTc interval.
Option A: All dopamine receptor antagonists are available and can be administered in oral form. Except for thioridazine, pimozide, and molindone, all other first-generation antipsychotics can also be given parenterally. Haloperidol and fluphenazine can be delivered in long-acting depot parenteral form.
Option B: Some antipsychotics can be monitored for a plasma therapeutic range. It is recommended to monitor plasma concentrations at a trough, which is at a minimum of 12 hours after the prior dose, and best at 20 to 24 hours after the last dose. Most antipsychotics do not have a well-defined dose-response curve.
Option D: Antipsychotics are widely used medications for a variety of mental health disorders. While effective, these drugs do have many potential side effects. Healthcare workers, working as an interprofessional team, need to be aware of the adverse effects because they can seriously affect the quality of life. To avoid the metabolic effects of these drugs, the patient needs to receive information regarding lifestyle changes. Regular exercise, discontinuation of smoking, and eating a healthy diet are essential.