Question

18\. For which client would the nurse expect the plan of care to include assessment using the Abnormal and Involuntary Movement Scale (AIMS)? a. Client with panic disorder b. Client with schizophrenia taking chlorpromazine (thorazine) c. Client with a mood disorder taking amitryptyline (Elavil)d. Client taking buproprion (Wellbutrin) e. Client taking paroxetine (Paxil)

Short answer

Client with schizophrenia taking chlorpromazine (Thorazine).

Step-by-step solution

Understand the AIMS purpose

The Abnormal Involuntary Movement Scale (AIMS) is used to detect and quantify tardive dyskinesia (TD), which are abnormal, involuntary movements primarily caused by long-term use of antipsychotic medications.

Identify medications causing TD

Review which medications are known to cause tardive dyskinesia. First-generation antipsychotics, like chlorpromazine (Thorazine), are the most common culprits. The other listed medications (amitryptyline, buproprion, paroxetine) are not typically associated with causing this condition.

Match the medication to the condition

Compare the correct use of medications. Chlorpromazine is used in treating schizophrenia, and it is known to have a risk of tardive dyskinesia. Therefore, the nurse would expect the plan of care to include assessment using the AIMS for this client.

Key concepts

tardive dyskinesia

Tardive dyskinesia (TD) is a condition characterized by repetitive, involuntary movements, often affecting the face, lips, and limbs. It's commonly caused by long-term use of antipsychotic medications. Early identification of TD is crucial as prolonged symptoms can become permanent.
Common symptoms of TD include:

• Facial grimacing
• Finger movements
• Jaw swinging
• Repetitive chewing
• Rapid eye blinking

Monitoring for early signs of TD can help manage and mitigate its progression through medication adjustment or discontinuation.

chlorpromazine

Chlorpromazine, also known by its brand name Thorazine, is a first-generation antipsychotic medication. It's primarily used to treat psychiatric conditions like schizophrenia and manic phases of bipolar disorder. While effective, chlorpromazine is associated with side effects like drowsiness, dizziness, and a high potential for causing tardive dyskinesia (TD).
Chlorpromazine works by blocking dopamine receptors in the brain, which helps reduce symptoms of psychosis, such as hallucinations and delusions. However, this same mechanism can lead to TD after prolonged use.
Understanding the risk profile is vital for healthcare providers to balance its therapeutic benefits with potential adverse effects.

schizophrenia

Schizophrenia is a severe mental disorder that affects how a person thinks, feels, and behaves. Symptoms include hallucinations, delusions, disorganized thinking, and impaired daily functioning. It often requires long-term treatment, including medications and psychotherapy.
Schizophrenia can severely impact quality of life and functioning, necessitating a comprehensive treatment plan. Antipsychotic medications, like chlorpromazine, play a significant role in managing the symptoms, but they come with risks such as tardive dyskinesia (TD).
Early intervention and consistent treatment adherence are critical in managing schizophrenia effectively.

antipsychotic medications

Antipsychotic medications are drugs primarily used to manage psychosis, particularly in disorders like schizophrenia and bipolar disorder. They are categorized into two main types: first-generation (typical) and second-generation (atypical) antipsychotics.
First-generation antipsychotics, like chlorpromazine, are known for their effectiveness but also their risk of causing severe side effects, such as tardive dyskinesia (TD).
Second-generation antipsychotics tend to have a lower risk of TD but can still cause other side effects, such as weight gain and metabolic syndrome.
Regular monitoring with tools like the AIMS assessment helps manage and mitigate potential adverse effects efficiently.

nursing assessment tools

Nursing assessment tools are critical in identifying, quantifying, and monitoring patient symptoms and side effects. The AIMS (Abnormal Involuntary Movement Scale) is a valuable tool for nurses, particularly when working with patients on antipsychotic medications.
The AIMS assessment involves a structured evaluation of involuntary movements in various body regions, including the face, lips, and limbs. Nurses rate these movements on a scale to determine the severity and progression of tardive dyskinesia (TD).
Using standardized tools not only promotes comprehensive care but also facilitates early intervention and better patient outcomes.