Drug Study

Generic Name: Haloperidol

Brand Name: Haldol

Classification: Antipsychotics
Alters the effects of dopamine in the CNS
Action: Also has anticholinergic and alpha-adrenergic blocking activity.
Diminished signs and symptoms of psychoses
Organic Psychoses
Acute psychotic symptoms
Indication / Uses: Relieve hallucinations, delusions, disorganized thinking
Severe anxiety
Seizures
Dosage, Frequency
5mg/amp BID
And Route:
CNS: extrapyramidal symptom such as muscle rigidity or spasm,
shuffling gait, posture leaning forward, drooling, masklike facial
appearance, dysphagia, akathisia, tardive dyskinesia, headache,
seizures.
CV: tachycardia, arrhythmias, hypertension, orthostatic hypertension.
Common Adverse EENT: blurred vision, glaucoma
Effects: GI: dry mouth, anorexia, nausea, vomiting, constipation, diarrhea,
weight gain.
GU: urinary frequency, urine retention, impotence, enuresis,
amenorrhea, gynecomastia
Hematologic: anemia, leukopenia, agranulocytosis
Skin: rash, dermatitis, photosensitivity
Seizure disorder
Contraindications: Glaucoma
Elderly clients
The drug is well and rapidly absorbed and has a high bioavailability.
Plasma-levels reach their maximum within 20 minutes after injection. The
Pharmacokinetics:
decanoate injectable formulation is for intramuscular administration only and
should never be used intravenously.
 Increases Drowsiness:
alcohol
barbiturates, eg amobarbital, phenobarbital
benzodiazepines, eg diazepam, temazepam
indometacin
MAOI antidepressants, eg phenelzine
sedating antihistamines, eg chlorphenamine, hydroxyzine
sleeping tablets, eg zopiclone
strong opioid painkillers, eg morphine, codeine, dihydrocodeine
tricyclic antidepressants, eg amitriptyline.
Abnormal heart rhythm, seen as a 'prolonged QT interval' on an ECG:
Interactions:
antiarrhythmics (medicines to treat abnormal heart beats), eg
amiodarone, procainamide, disopyramide, sotalol
the antihistamines astemizole, mizolastine or terfenadine
atomoxetine
certain antidepressants, eg amitriptyline, imipramine, maprotiline
certain antimalarials, eg halofantrine, chloroquine, quinine, mefloquine,
Riamet
certain other antipsychotics, eg thioridazine, chlorpromazine, sertindole
cisapride
intravenous erythromycin or pentamidine
moxifloxacin.
Assess mental status prior to and periodically during therapy.
Monitor BP and pulse prior to and frequently during the period of
dosage adjustment. May cause QT interval changes on ECG.
Observe patient carefully when administering medication, to ensure that
medication is actually taken and not hoarded.
Monitor I&O ratios and daily eight. Assess patient for signs and
symptoms of dehydration.
Monitor for development of neuroleptic malignant syndrome (fever,
respiratory distress, tachycardia, seizures, diaphoresis, hypertension or
Nursing
hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder
Considerations:
control. Report symptoms immediately. May also cause leukocytosis,
elevated liver function tests, elevated CPK.
Advise patient to take medication as directed. Take missed doses as
soon as remembered, witih remaining doses evenly spaced through out
the day. May require several weeks to obtain desired effects. Do not
increase dose or discontinue medication without consulting health care
professional. Abrupt withdrawal may cause dizziness, nausea, vomiting,
GI upset, trembling, or uncontrolled movements of mouth, tongue or
jaw.
 Reading
More than 90 people have died and the death toll is still rising after a chaotic and disastrous government decision
to transfer psychiatric patients from hospitals to unlicensed private care homes in South Africa. The growing
scandal has rocked South Africa, with fresh revelations of more deaths on Wednesday as investigators pursue the
case. Senior officials were repeatedly warned of the risk of the patient-transfer scheme, yet they pushed ahead
with it anyway. One factors that this incident happen was the government cost-cutting campaign that went
wrong, private homes that saw the psychiatric patients as a business opportunity, appalling living conditions that
sometimes resembled those of a concentration camp and senior officials who ignored all warnings of looming
disaster. Because I was so shocked with these news i tend to search more and read that some of the patients were
transferred to the private homes in the back of pickup trucks or were tied with bedsheets during their transfer, the
report found. They had been receiving specialised care at their hospitals before the transfer, but they were sent to
homes without doctors, nurses or other qualified staff. Some of the homes lacked proper food, water, medicine
and even heating in the winter. Many patients died of dehydration, heart attacks, diarrhoea and pneumonia. Some
had become emaciated from hunger. In many cases, the causes of death are still unknown.This paints a picture of
a health-care system that is grossly mismanaged and has been entrusted to people incapable of effectively
serving the public interest. Why would the government do these kind of decision when they already know the
risk before embarking on this project and just watched as the tragedy unfolded. It really paints a picture of a
government with no regard for the lives of some of the most marginalised people in our society people with
severe mental health problems .This is just inhumane and callous disregard for the lives of others.
TIME CUES NEE N U R S I N G G O A L O F INTERVENTIONS EVALUATION
AND D DIAGNOSI CARE
DATE S
Febru C I m p a i r e d At the end of 1 1. Provide opportunities for February 18 2017
a r y OBHECTIVE: O m e m o r y week nursing reminiscence or recall past
1 8 Disorientat G related to c a r e , the events GOAL NOT MET
2017 ion to time N neurological patient will be Long-term memory may The patient was
@7:3 Observed I disturbances able to: persist after loss of recent NOT able to
0 PM experience T Impaired Verbali memory. Reminiscence is verbalise awareness
o f I memory is z e usually an enjoyable activity of memory
forgetting V directly awaren for the client. problems as he
Hallucinati E related to ess of verbalised
on is - effects of memor 2. Encourage the client to use The patient was
present P general y written cues such as calendars also not able to
Inability to E medical proble or notebooks v e r b a l i s e
determine R condition or m s ; Written cues decrease the acceptance of his
if a C ongoing and c l i e n t s n e e d t o r e c a l l limitations due to
behaviour E effects of Accept activities, plans and so on his conditions
i s P substance. limitati from memory.
performed T Depending o ons of 3. Encourage ventilation of
Mur murs U n the areas current feelings of frustration,
to himself A of the brain, conditi helplessness, and so forth.
L the client on Refocus attention to areas of
are unable focus and progress.
to recall To lessen feelings of
information, powerlessness/hopelessness
e i t h e r 4. Provide for proper pacing of
remote or activities and having
recent. The appropriate rest
client may To avoid fatigue
confabulate 5. Allow the client to do tasks
to fill in on his own, but do not rush
those lost him to do it. Make the client
memories. feel that he can still do things
independently.
It is important to maximize
independent function, assist
the client when memory has
deteriorated further.
C At the end of 3 6. Assist the client deal with
O day nursing functional limitations and
G care, the identify resources.
N patient will be To meet individual needs,
I able to: maximizing independence.
T Verbali 7. P r o v i d e s i n g l e s t e p
I ze instructions when
V awaren instructions are needed.
E ess of Client with memory
- memor impairment cannot remember
P y multistep instructions
E proble 8. Do not contradict the client
R ms; who experiences an illusion.
C and Instead, simply explain
E Accept r e a l i t y, a n d f i n d s o m e
P limitati practical solutions to the
T ons of problem
U current Therapeutic responses
A conditi promote reality while
L on offering solutions that help
enhances the clients sense
and may reduce fear, anxiety,
and confusion.
9. Monitor clients behavior and
assist in use of stress-
management techniques
To reduce frustration
10. Determine clients response
to medication medications
prescribe to improve
attention, concentration,
memory process and to lift
spirits and modify emotional
responses.
Helpful in deciding whether
quality of life is improved
when using the medications
prescribed.
Psychiatric Nursing Requirements

Submitted to:
Melba Irene Gabuya, RN , MN

Submitted by:
[Group 1]
Aya Basilio

Date:
February 18, 2017
 Mental Status Examination

General Appearance

During nurse- patient interaction, the patients grooming was not good prior
to morning care but on the later part he improves and shows good grooming.
Most of the time, he exhibited appropriate facial expressions and posture
during interactions. At first, he cannot display eye contact which may show
lack of focused and interest on the topic. As time passes he is having an
hallucination losing more focused unto the interaction.

General Mobility Posture and Gait

The patient still slouches when seated but holds himself erect when standing
and walking. His mannerisms are still present and evident throughout the
interview.

Activity
During the interview, the patient was able to sit straight andfocus on
answering the questions asked to him. There is no overactivityor
underactivity nor impulsiveness noted. He was very calm andcomposed along
the interview.c.Facial Expression The patient was able to exhibit
appropriate facialexpression towards a certain topic