A client experiencing an acute dystonic reaction presents with a laryngeal spasm. Which treatment should the nurse prepare?
A.
Intravenous administration of benztropine.
B.
Oral administration of divalproex.
C.
Intravenous administration of isotonic crystalloid fluid.
D.
Oral administration of lorazepam.
The correct answer and Explanation is :
The correct answer is A. Intravenous administration of benztropine.
Explanation:
An acute dystonic reaction is a type of extrapyramidal side effect commonly associated with the use of antipsychotic medications, especially those that block dopamine receptors. This reaction can include muscle spasms, oculogyric crisis, and laryngeal spasms, which can potentially be life-threatening due to airway obstruction.
Benztropine is an anticholinergic medication that is effective in treating acute dystonic reactions. It works by counteracting the effects of excess acetylcholine in the central nervous system, which is responsible for the involuntary muscle contractions and spasms associated with dystonia. In cases of severe dystonia, especially with laryngeal spasm, benztropine is usually administered intravenously to provide rapid relief and to quickly counteract the acute symptoms.
Why Not the Other Options:
- B. Oral administration of divalproex: Divalproex is an anticonvulsant and mood stabilizer, often used for treating seizures, bipolar disorder, and sometimes as a prophylactic treatment for migraine. It is not effective in the acute management of dystonic reactions.
- C. Intravenous administration of isotonic crystalloid fluid: Isotonic crystalloid fluids, like normal saline, are used for hydration and to restore fluid balance. They do not have any effect on dystonic reactions or muscle spasms and would not address the acute dystonia or laryngeal spasm.
- D. Oral administration of lorazepam: Lorazepam is a benzodiazepine that can help with anxiety and some types of muscle spasm but is not typically the first-line treatment for acute dystonia. Benzodiazepines are not as effective as anticholinergics in managing dystonic reactions.
In summary, benztropine is the appropriate choice for treating an acute dystonic reaction with laryngeal spasm due to its specific action on the neurotransmitter imbalances that cause these symptoms.