A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?
Shuffling gait
Sudden onset of high fever
Constant tapping of feet when sitting
Twisting tongue movements
The Correct Answer is D
A. A shuffling gait is more commonly associated with parkinsonism, a side effect of antipsychotic medications, rather than tardive dyskinesia.
B. A sudden onset of high fever could indicate neuroleptic malignant syndrome (NMS), which is a serious reaction to antipsychotic medications, not tardive dyskinesia.
C. Constant tapping of feet when sitting can indicate restlessness or akathisia, but it does not specifically represent tardive dyskinesia.
D. Twisting tongue movements are a classic manifestation of tardive dyskinesia, characterized by involuntary, repetitive movements of the face, tongue, and extremities, which may develop after long-term use of antipsychotic medications like fluphenazine.
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Correct Answer is D
Explanation
A. Paroxetine is an SSRI antidepressant used for depression and anxiety disorders, not for Parkinson's Disease.
B. Lisinopril is an ACE inhibitor primarily used for hypertension and heart failure, and it does not address symptoms of Parkinson's Disease.
C. Risperidone is an atypical antipsychotic that may be used in some cases for behavioral symptoms but is not a primary treatment for Parkinson's Disease.
D. Levodopa (Inbrija) is a medication specifically indicated for the management of Parkinson's Disease, as it helps to replenish dopamine levels, alleviating motor symptoms associated with the disease.
Correct Answer is D
Explanation
A. Diabetes Mellitus is not a contraindication for promethazine, although caution may be needed regarding metabolic control.
B. Chronic Kidney Disease does not specifically contraindicate the use of promethazine, but dosage adjustments may be necessary due to altered drug metabolism.
C. Iron Deficiency Anemia does not contraindicate the use of promethazine and would not raise significant concerns for its administration.
D. Narrow-Angle Glaucoma is a contraindication for promethazine due to its anticholinergic properties, which can increase intraocular pressure and worsen glaucoma.