A patient on treatment for Schizophrenia complains about a persistent feelings of restlessness and says "I feel like I need to move all the time." What should a nurse do?

Question

Question

This question was previously asked in

KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: Assess the patient for other extrapyramidal symptoms

Rationale:

The patient’s complaint of persistent restlessness and the need to move constantly is indicative of akathisia, a common extrapyramidal symptom (EPS). Extrapyramidal symptoms are side effects of antipsychotic medications, particularly first-generation antipsychotics, which affect the dopaminergic pathways in the brain.
Akathisia is characterized by an inner sense of restlessness, inability to stay still, and constant movement, such as pacing or fidgeting. It is essential for the nurse to assess the patient for other EPS like dystonia (muscle contractions), parkinsonism (tremors, rigidity, bradykinesia), or tardive dyskinesia (involuntary movements).
A thorough assessment will help determine the severity of the symptoms and guide appropriate interventions, which may include adjusting the medication dosage, switching to another antipsychotic, or prescribing medications like beta-blockers or anticholinergics to manage EPS.

Explanation of Other Options:

Ask the patient to take rest

Rationale: While rest may seem like a logical suggestion, it does not address the underlying cause of the patient’s restlessness. Akathisia is a physiological side effect of antipsychotic medications and cannot be relieved through rest alone. This approach risks dismissing the patient’s concerns and may lead to frustration or noncompliance with treatment.

Ask the patient to go for a walk

Rationale: Encouraging physical activity like walking may provide temporary relief for the patient’s restlessness but does not address the root cause of akathisia. This option might also overlook the need for a detailed assessment to identify the severity and other possible EPS symptoms.

Educate the patient about psychomotor agitation associated with Schizophrenia

Rationale: Psychomotor agitation is a symptom of schizophrenia, but the patient’s description of restlessness and constant movement is more likely related to akathisia caused by antipsychotic medication. Educating the patient about psychomotor agitation may confuse them and divert attention from addressing the medication side effects.

Conclusion:

Assessing for extrapyramidal symptoms is the correct approach as it allows the nurse to identify akathisia and other potential side effects of antipsychotic medications. Early recognition of EPS is crucial for providing appropriate interventions, improving patient comfort, and ensuring compliance with treatment.
Understanding the nature of akathisia and distinguishing it from psychomotor agitation or other conditions is vital for providing effective care and improving the patient's overall quality of life.