Question

Multiple-choice question: Twenty minutes after administering the prochlorperazine (Compazine), the nurse enters Joyce's room and finds that she is anxious, restless, and agitated. The nurse should prepare to administer an IV dose of: A. Naloxone (Narcan) B. Flumazenil (Romazincon) C. Diphenhydramine (Benadryl) D. Protamine sulfate

Short answer

The correct drug to administer in this case is C. Diphenhydramine (Benadryl).

Step-by-step solution

Identify the Problem

Joyce has been given prochlorperazine and is presenting with anxiety, restlessness, and agitation. These symptoms are likely extrapyramidal symptoms (EPS) which are common side effects of prochlorperazine.

Understand the Role of the Different Drugs

Naloxone (Narcan) is used to reverse the effects of opioids. Flumazenil (Romazincon) is used to reverse the effects of benzodiazepines. Diphenhydramine (Benadryl) is an antihistamine that can also be used to control the symptoms of EPS. Protamine sulfate is used to counteract heparin.

Select the Correct Drug for the Symptoms

According to the symptoms presented by Joyce, and considering that these symptoms are likely EPS side effects from the prochlorperazine, the correct antidote for these symptoms is diphenhydramine (Benadryl).

Key concepts

Extrapyramidal Symptoms (EPS)

Extrapyramidal Symptoms (EPS) are a set of drug-induced movement disorders that can occur as adverse effects of certain medications, particularly antipsychotics like prochlorperazine. These symptoms can manifest in various ways, including acute dystonia (sudden muscle contractions), akathisia (a feeling of inner restlessness), Parkinsonism (symptoms similar to those of Parkinson's disease), and tardive dyskinesia (involuntary, repetitive body movements).

The management of EPS is crucial as they can greatly impact a patient's quality of life. The administration of anticholinergic medications, such as benztropine, or antihistamines, such as diphenhydramine, can help alleviate these symptoms by counteracting the effects of the drugs causing them. EPS are often reversible if recognized early and treated promptly.

Prochlorperazine Adverse Effects

Prochlorperazine, also known as Compazine, is commonly used as an antiemetic and antipsychotic medication. While effective, it is not without potential adverse effects, which include but are not limited to Extrapyramidal Symptoms (EPS). Other possible adverse effects that patients may experience are sedation, hypotension, anticholinergic effects (such as dry mouth, blurred vision, constipation, and urinary retention), and rarely, Neuroleptic Malignant Syndrome (a life-threatening condition).

Understanding these adverse effects is paramount when prescribing and administering prochlorperazine. Nurses and healthcare providers should closely monitor patients and be prepared to address any adverse reactions to ensure patient safety and comfort.

Nursing Pharmacological Interventions

When managing medication side effects, nursing pharmacological interventions play a vital role in patient care. Nurses must possess the knowledge and skills necessary to identify adverse reactions, like EPS from prochlorperazine, and take appropriate action. This includes administering counteracting medications, such as diphenhydramine (Benadryl), and providing supportive care.

It's also essential for nurses to educate patients about the potential side effects of their medications and what to do if they experience any symptoms. Moreover, nurses should ensure that interventions are documented and communicated to the entire healthcare team to ensure continuity of care. Proper intervention can mean the difference between a minor side effect and a major complication for a patient.