A client experiencing an acute dystonic reaction presents with a laryngeal spasm. Which treatment should the nurse prepare?
Intravenous administration of benztropine.
Oral administration of divalproex.
Intravenous administration of isotonic crystalloid fluid.
Oral administration of lorazepam.
The Correct Answer is A
A) Correct - Acute dystonic reactions are involuntary muscle spasms caused by certain medications, including antipsychotic drugs. These reactions can sometimes affect the muscles of the face and neck, including the larynx. Benztropine is an anticholinergic medication commonly used to treat acute dystonic reactions. It works by blocking certain neurotransmitters that contribute to muscle spasms, helping to relieve the symptoms.
B) Incorrect - Divalproex is an anticonvulsant medication primarily used to treat epilepsy and bipolar disorder. It is not the appropriate treatment for acute dystonic reactions. These reactions are usually caused by certain antipsychotic medications and are characterized by sudden and involuntary muscle contractions. Divalproex does not have the specific mechanism of action needed to alleviate the symptoms of acute dystonic reactions.
C) Incorrect - Isotonic crystalloid fluids are used for various purposes, such as fluid resuscitation, maintaining hydration, and balancing electrolytes. However, they are not a treatment for acute dystonic reactions. These reactions are neurological and musculoskeletal in nature and require medications with specific anticholinergic properties, like benztropine, to address the underlying issue.
D) Incorrect - Lorazepam is a benzodiazepine commonly used for anxiety, sedation, and seizure control. While it can have a relaxing effect on muscles, it is not the first-line treatment for acute dystonic reactions. Anticholinergic medications like benztropine are more appropriate because they directly counteract the neurotransmitter imbalances that lead to muscle spasms in these reactions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A high blood urea nitrogen (BUN) level indicates impaired renal function, which can be caused by dehydration, infection, or nephrotoxic drugs. Chemotherapy can damage the kidneys and increase the risk of renal failure. The PN should report this finding to the charge nurse, as it may require fluid replacement, dose adjustment, or discontinuation of the chemotherapy.
The other options are not correct because:
- Periodic nausea and vomiting are common side effects of chemotherapy that can be managed with antiemetics, hydration, and dietary modifications. They are not as urgent as a high BUN level.
- Decreased deep tendon reflexes may indicate hypocalcemia, hypomagnesemia, or peripheral neuropathy, which can be caused by chemotherapy or other factors. They are not as urgent as a high BUN level.
- A platelet count of 135,000/mm3 or 135 x 10^9/L is slightly below the normal range, but not significantly low. Chemotherapy can cause thrombocytopenia, which increases the risk of bleeding. The PN should monitor the client for signs of bleeding, but this finding is not as urgent as a high BUN level.
Correct Answer is D
Explanation
A) Incorrect- While notifying the healthcare provider is an important step to take after an error, it's not the first action the nurse should take. The immediate concern is the client's safety and well-being, so assessing the client for any adverse effects of the incorrect dose is the priority.
B) Incorrect- Documentation is important, but it's not the first action to take after administering an incorrect medication dose. The nurse should prioritize assessing the client for any adverse effects and ensuring their immediate safety.
C) Incorrect- Completing an incident report is an important step to document errors and prevent future occurrences, but it's not the initial action to take. First, the nurse should focus on the client's well-being by assessing for adverse effects.
D) Correct- Assessing the client for any adverse effects is the immediate priority when an incorrect dose of medication has been administered. The nurse's first concern is the safety and health of the client. Once the client's condition has been assessed and stabilized, further actions can be taken, such as notifying the healthcare provider and completing incident reports.
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