PGIMER Chandigarh NO - 2015
Mental Health Nursing
Easy
An Extra pyramidal symptom that is a potentially irreversible side effect of antipsychotic drugs is?
Appeared in: PGIMER Chandigarh NO - 2015
Explanation
- Tardive Dyskinesia (TD) is a delayed-onset extrapyramidal symptom (EPS) that can occur after prolonged use of antipsychotic medications, typically for at least a few months.
- It is characterized by involuntary, repetitive movements, most commonly affecting the face, such as lip smacking, tongue protrusion, and grimacing.
- The key differentiator is its potential for irreversibility; the movements may persist even after the offending drug is discontinued, unlike other acute EPS.
Why Other Options Were Wrong
- Option A: Torticollis is a form of acute dystonia, a type of EPS that occurs early in treatment (hours to days) and is reversible with prompt anticholinergic treatment.
- Option C: Oculogyric crisis is also a form of acute dystonia, like torticollis. It is an acute, reversible side effect, not a potentially irreversible one.
- Option D: Akathisia is characterized by a subjective feeling of inner restlessness and is a common EPS. It is generally considered reversible and is managed by dose reduction or specific medications like beta-blockers.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Side Effects of Antipsychotic Medications helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses play a crucial role in monitoring for TD using standardized tools like the Abnormal Involuntary Movement Scale (AIMS) at baseline and regular intervals for any patient on long-term antipsychotics.
- Early detection and reporting of any new, involuntary movements to the prescribing provider is critical, as it may prompt a change in medication (e.g., switching to a lower-risk atypical antipsychotic) and improve the patient's prognosis.
- Patient education is vital. Nurses must teach patients and their families to report any unusual movements of the face, tongue, or limbs immediately, and emphasize the importance of not stopping medication abruptly.
How to Approach the Question
- First, identify the key terms in the question: "Extra pyramidal symptom" (EPS), "potentially irreversible," and "antipsychotic drugs."
- The most critical keyword is "irreversible." This immediately directs your thinking toward a long-term, potentially permanent side effect rather than an acute, treatable one.
- Recall the different types of EPS. Mentally categorize them into acute/early onset (dystonia, akathisia, parkinsonism) and delayed/late onset (tardive dyskinesia).
- Evaluate each option based on this categorization. Torticollis and Oculogyric crisis are types of acute dystonia, which are reversible.
- Akathisia is also an early-onset symptom that is typically reversible.
- This leaves Tardive Dyskinesia, which is known for its late onset and potential for being irreversible, making it the correct answer.
Concept Tested & Keywords
- Concept Tested: Side Effects of Antipsychotic Medications
- Stem keywords: Extra pyramidal symptom, irreversible side effect, antipsychotic drugs
- Lead-in keywords: is
- Negative lead-in flag: false
Question ID
QlMNxYltxfRR91jLmGjPSP
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1891-1893
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 10037-10039, 3903-3905
Practise the full PGIMER Chandigarh NO - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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