A nurse is assessing a client who is taking haloperidol and is experiencing pseudoparkinsonism.
Which of the following findings should the nurse document as a manifestation of pseudoparkinsonism?
A.
Nonreactive pupils.
B.
Serpentine limb movement.
C.
Smacking lips.
D.
Shuffling gait.
The correct answer and Explanation is :
Correct Answer: D. Shuffling gait
Explanation:
Pseudoparkinsonism is a drug-induced syndrome resembling Parkinson’s disease, often caused by the use of antipsychotic medications such as haloperidol, a potent dopamine antagonist. When dopamine is blocked in the central nervous system, it disrupts the balance between dopamine and acetylcholine, leading to motor symptoms that resemble Parkinson’s disease. These symptoms can include tremors, rigidity, bradykinesia (slowness of movement), and postural instability.
The hallmark signs of pseudoparkinsonism include:
- Shuffling gait (Answer D): This is a distinctive feature, where the client has difficulty initiating movement, takes small, shuffling steps, and often drags their feet.
- Bradykinesia: A generalized slowing of movement, making routine tasks difficult.
- Rigidity: Increased muscle tone, leading to stiffness and resistance to movement.
- Resting tremor: Involuntary shaking of the hands or other parts of the body when at rest.
- Masked facies: A lack of facial expression due to reduced facial muscle activity.
- Stooped posture: A forward-leaning posture is often seen in individuals with pseudoparkinsonism.
Incorrect Options:
- A. Nonreactive pupils: This is not a sign of pseudoparkinsonism. Pupil reactivity issues are more commonly associated with brain injuries or conditions like anticholinergic toxicity.
- B. Serpentine limb movement: This describes choreiform movements, which are more associated with tardive dyskinesia, another side effect of antipsychotics, but not pseudoparkinsonism.
- C. Smacking lips: This is a manifestation of tardive dyskinesia, characterized by repetitive, involuntary movements of the mouth, lips, or tongue, but not of pseudoparkinsonism.
Nursing Implications:
Early recognition and documentation of pseudoparkinsonism are crucial. The nurse should notify the healthcare provider, as dose adjustments or switching to a different medication may be necessary. Additionally, medications like anticholinergics (e.g., benztropine) may be prescribed to alleviate symptoms.