A client taking chlorpromazine presents with a stooped posture, shuffling gait, and tremors. Which potential side effect should the nurse suspect?

Choice A reason: Pseudoparkinsonism is an extrapyramidal side effect characterized by tremors, bradykinesia, and rigidity. However, it is typically considered an intermediate or short-term side effect that appears within days to weeks of starting medication and usually resolves upon discontinuation or dose reduction, rather than being a permanent long-term manifestation.

Choice B reason: Tardive dyskinesia is a potentially irreversible long-term side effect of prolonged antipsychotic use, particularly first-generation agents. It involves involuntary, repetitive movements such as lip-smacking, tongue protrusion, and grimacing. It results from dopamine receptor supersensitivity in the nigrostriatal pathway after years of chronic dopamine blockade and receptor upregulation.

Choice C reason: Akathisia is characterized by a distressing internal sense of restlessness and an urgent need to move, often manifesting as pacing or inability to sit still. While it can persist, it is generally classified as an acute or subacute extrapyramidal symptom rather than the classic long-term choreoathetoid movement disorder.

Choice D reason: Acute dystonia involves sudden, involuntary muscle contractions of the face, neck, or trunk, often occurring within the first few days of antipsychotic initiation. Because it occurs so early in the treatment trajectory, it is categorized as an acute emergency rather than a late-onset or long-term complication of therapy.

Choice A reason: Progressive muscle relaxation involves the tensing and releasing of various muscle groups. While this can be helpful for generalized anxiety, it is often ineffective for medication-induced restlessness, such as akathisia. The physical discomfort from antipsychotic side effects is neurochemical in nature and typically requires pharmacological adjustment rather than behavioral relaxation.

Choice B reason: Akathisia is a common extrapyramidal side effect of antipsychotic medications, characterized by an intense internal sense of restlessness and a compelling need to move. The most direct and effective medical intervention is to advocate for a reduction in the medication dosage or a change in the drug itself to alleviate the dopamine-related neurological stimulus causing the distress.

Choice C reason: Group therapy is generally used to improve social skills, provide emotional support, or process shared experiences. It does not address the underlying physiological or neurological causes of medication-induced restlessness. Expecting a client with severe physical restlessness to sit through a group session may actually increase their agitation and discomfort.

Choice D reason: Mindfulness meditation focuses on present-moment awareness and non-judgmental acceptance of sensations. While beneficial for stress, a client experiencing acute akathisia often finds it physically impossible to sit still for meditation. The priority must be resolving the physiological adverse reaction through medication management before behavioral or mindfulness-based interventions can be successfully utilized.