The nurse is doing an admission assessment on a client with schizophrenia. Which of the following are positive symptoms of schizophrenia?

C. Tardive dyskinesia is a movement disorder characterized by repetitive, involuntary movements of the face, tongue, and sometimes other parts of the body. These movements can include lip smacking, tongue protrusion, grimacing, and rapid eye blinking. Tardive dyskinesia is a well-known adverse effect associated with long-term use of antipsychotic medications, particularly first- generation antipsychotics such as chlorpromazine.
A. Neuroleptic Malignant Syndrome is a rare but serious adverse reaction to antipsychotic medications, characterized by symptoms such as severe muscle rigidity, high fever, altered mental status (e.g., confusion), autonomic instability (e.g., fluctuations in blood pressure, heart rate), and elevated creatine phosphokinase (CPK) levels.
B. Dysthymia is a chronic mood disorder characterized by persistent feelings of sadness, hopelessness, and low self-esteem. Dysthymia is not directly related to the involuntary movements described in the scenario and is unlikely to be the cause of the client's symptoms.
D. Akathisia is a movement disorder characterized by inner restlessness and the inability to sit still. Akathisia is a common side effect of antipsychotic medications and can be distressing for affected individuals. However, the symptoms described in the scenario, specifically involuntary movements of the tongue and face, are more indicative of tardive dyskinesia rather than akathisia.

A. Fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) typically require several weeks of treatment before the full therapeutic effects are realized. Therefore, it's important for the nurse to reassure the client that it may take some time for the medication to alleviate depressive symptoms fully.

B. While lack of improvement in depressive symptoms after two weeks of fluoxetine treatment may be concerning, it's generally recommended to wait at least 4 to 6 weeks before considering changing or adjusting the antidepressant regimen.

C. Monoamine oxidase inhibitors (MAOIs) are another class of antidepressant medications that may be considered for treatment-resistant depression. However, MAOIs have significant dietary and medication restrictions and carry the risk of potentially serious drug interactions.

D. While sleep disturbances are common in major depressive disorder, recommending a sleep study as the first intervention for a client who is not responding to antidepressant treatment after only two weeks may not be the most appropriate action.