Final Exam Review
Extrapyramidal Symptoms: involuntary movements
1st Generation Antipsychotics Complications:
● Akinesia:
○ Inability to sit or
... [Show More] stand still
○ Continual pacing and agitation
● Parkinsonism:
○ Rigidity
○ Tremors
○ Shuffling gait
○ Drooling
○ Bradykinesia
■ Slow movements
● Dystonia:
○ Severe spasms of tongue, neck, face, and back
○ Crisis situation
● Tardive Dyskinesia (Late EPSs)
○ Involuntary movements of the tongue and face
■ Arms, legs, and trunk as well
● Manage with: Think ABCs
○ Trihexyphenidyl: Artane
○ Diphenhydramine: Benadryl
○ Benztropine: Cogentin
Children/adolescents
○ Conduct disorder
■ Demonstrate a persistent pattern of behavior that violates the rights of
others or rules and norms of society
■ Categories
● Aggression toward animals or people
● Destruction of property
● Deceitfulness or theft
● Serious violations of rules
■ Childhood onset develops before the age of 10
● More prevalent in males
■ Contributing factors
● Parental rejection or neglect
● Difficult infant temperament
● Physical or sexual abuse
● Lack of supervision
● Early institutionalization
● Large family size
● Association with delinquent peer groups
● Parental history of psychological issues
■ Manifestations
● Lack of remorse or care for the feelings of others
● Bullies, threatens, or intimidates others
● Believes aggression is justified
● Exhibits low self-esteem
● Temperamental outbursts
● May demonstrate suicidal ideation
● Concurrent learning disorders
● Destroys property of others
● Often lies and/or shoplifts
○ Autism
■ Neurodevelopmental disorder thought to be of genetic origin with
behaviors that affect an individual's ability to communicate and interact
with others.
■ Cognitive and language development are typically delayed
■ More common in boys than girls
■ Can range from poor to high functioning ability
■ Nursing interventions
● Provide structured environment
● Encourage parents to participate in child’s care
● Use short and concise communication
● Reward for good behavior
● Role-model social skills
● Limit self-stimulating and ritualistic behaviors
● Determine emotional and situational triggers
● Ensure safety and monitor behavior for risks
■ Typically SSRI and antipsychotic meds are given such as Risperidone or
Olanzapine
■ Characteristics
● Sensory integration dysfunction
● Sleep disorders
● Digestive disorders
● Feeding disorders
● Epilepsy
● Ritualistic or repetitive behavior
● Children Medication:
○ Ritalin (methylphenidate) p.146
○ Used in ADHD
○ CNS stimulant
○ Administer last dose before 4pm or patient will not be able to sleep
○ Do not take caffeine/tea/cola/chocolate (will enhance effect)
○ Can be used for adults and children
○ Side effects:
■ Palpitations or dysrhythmias
■ Increase blood pressure
■ Weight gain
■ Monitor vitals
■ Insomnia or restlessness
○ Contraindications:
■ Pregnancy
■ Cardiovascular disorders
■ Substance abuse
○ Administration:
■ Oral 30-40 min before meals
■ Not after 4pm, keep them awake
■ No alcohol usage
■ Monitor vital signs and ECG
■ May take 6 weeks to see full effect
○ Tolerance:
■ can cause substance use disorders
■ Should not be stopped abruptly
● Can cause depression and severe fatigue
○ Patch:
■ Apply to hip in the morning
■ leave no longer than 9 hours [Show Less]