A nurse is caring for an adolescent client who begins to cry and states, "Nobody loves me. I don't deserve to be here!" Which of the following responses should the nurse make?

A) Olanzapine: Olanzapine is an atypical antipsychotic that is used to treat conditions such as schizophrenia and bipolar disorder, but it would not be used to treat severe muscle spasms caused by chlorpromazine. This medication is not appropriate for managing extrapyramidal side effects (EPS) like the muscle spasms described in the question.

B) Flumazenil: Flumazenil is a benzodiazepine antagonist used for the reversal of benzodiazepine overdoses or excessive sedation, but it is not indicated for managing the side effects of antipsychotic medications like chlorpromazine. The symptoms described in the question are more related to extrapyramidal symptoms rather than benzodiazepine toxicity.

C) Fluphenazine: Fluphenazine is another antipsychotic medication within the same class as chlorpromazine (typical antipsychotics). Administering fluphenazine would not treat the muscle spasms or other side effects caused by chlorpromazine. In fact, it may worsen the symptoms. The focus should be on managing the side effects rather than increasing the antipsychotic dosage.

D) Benztropine: Benztropine is an anticholinergic medication used to treat extrapyramidal symptoms (EPS), such as muscle spasms, rigidity, and tremors, which are common side effects of typical antipsychotics like chlorpromazine. This medication would be ordered to relieve the severe neck and back spasms the patient is experiencing as a result of the chlorpromazine.

A) Tardive dyskinesia: Tardive dyskinesia is a late-onset movement disorder that causes repetitive, involuntary movements, such as tongue protrusion or lip smacking. It typically develops after long-term use of antipsychotics like fluphenazine. Since the client reports restlessness shortly after starting the medication, this is unlikely to be tardive dyskinesia, which takes months to years to develop.

B) Pseudoparkinsonism: Pseudoparkinsonism is a side effect of antipsychotics that causes symptoms similar to Parkinson's disease, such as tremors, rigidity, and bradykinesia. While restlessness is not a hallmark symptom of pseudoparkinsonism, it could lead to a lack of coordination or stiffness, but it does not explain the client's feeling of being restless all the time.

C) Akathisia: Akathisia is a common side effect of antipsychotics, including fluphenazine. It is characterized by an intense feeling of restlessness and an inability to sit still, often accompanied by an urge to move. This matches the client's description of being restless and unable to sit still, making akathisia the most likely cause of their symptoms.

D) Acute dystonia: Acute dystonia involves painful, muscle spasms or abnormal postures, such as twisting of the neck or eyes rolling back, which can occur shortly after taking antipsychotics. However, this condition typically causes muscle rigidity or spasms rather than the restlessness that the client describes, making it less likely in this case.