A nurse is assessing for the presence of extrapyramidal side effects (EPS) in a client who is taking chlorpromazine.
Which of the following findings should the nurse recognize as EPS? (Select all that apply.).
A.
Sexual dysfunction.
B.
Muscle spasms of the neck.
C.
Tremors of the hands.
D.
Fidgeting behavior.
E.
Blurred vision.
The Correct Answer and Explanation is:
The correct answers are B. Muscle spasms of the neck, C. Tremors of the hands, and D. Fidgeting behavior.
Explanation:
Extrapyramidal side effects (EPS) are drug-induced movement disorders commonly associated with antipsychotic medications, such as chlorpromazine, which is a typical antipsychotic. EPS are a group of symptoms that affect the motor system and can include various involuntary movements and muscular symptoms.
- Muscle Spasms of the Neck (B): This is indicative of acute dystonia, a type of EPS. Dystonia involves sustained muscle contractions and abnormal postures, which can occur suddenly and may include muscle spasms in various parts of the body, such as the neck (cervical dystonia). Acute dystonia is a serious condition that requires prompt treatment, often with anticholinergic medications like benztropine or diphenhydramine.
- Tremors of the Hands (C): This is an example of Parkinsonism, another form of EPS. Parkinsonism includes symptoms similar to those of Parkinson’s disease, such as tremors (shaking), bradykinesia (slowness of movement), rigidity, and postural instability. Tremors are particularly common and can affect the hands, giving a characteristic resting tremor.
- Fidgeting Behavior (D): This is indicative of akathisia, which is characterized by an inner feeling of restlessness and a compelling need to be in constant motion. Patients may exhibit fidgeting behavior, pacing, or an inability to sit still. Akathisia can be distressing and may require adjustment of medication or additional treatment with beta-blockers or benzodiazepines.
Sexual Dysfunction (A) and Blurred Vision (E) are not typically considered EPS. Sexual dysfunction is more related to the anticholinergic or hormonal effects of the medication, while blurred vision may result from anticholinergic properties or other side effects but is not classified under EPS.
In summary, EPS from antipsychotic medications like chlorpromazine can significantly impact a patient’s quality of life and require careful monitoring and management by healthcare providers. Identifying and treating these symptoms early is crucial to ensure effective and comfortable treatment.