NEUROLEPTIC MALIGNANT SYNDROME: Liability in Nursing Practice

Dt, Blair; Dauner, A

doi:10.3928/0279-3695-19930201-06

J Psychosoc Nurs Ment Health Serv

1993

DOI: 10.3928/0279-3695-19930201-06

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NEUROLEPTIC MALIGNANT SYNDROME: Liability in Nursing Practice

Blair Dt¹,

A Dauner²

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Cited by 5 publications

References 28 publications

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A survey of psychiatric nurses' opinions of advanced practice roles in psychiatric nursing

Allen

1998

Psychiatric Ment Health Nurs

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This postal survey established psychiatric nurses' opinions of the content of advanced practice psychiatric nursing roles. A random sample, consisting of 100 members of the Network for Psychiatric Nursing Research (NPNR), was surveyed. 78% returned completed questionnaires. Responses were analysed using the chi-square test, and the Mann-Whitney U-test. Elements of the normal nursing role identified included psychiatric assessment, patient and carer education, and basic psychotherapeutic practices. Identified advanced practice roles included psychiatric diagnoses, prescribing single emergency doses and modifying doses of a wide range of psychotropic medication. Enhanced autonomy in admission and discharge and additional powers under the Mental Health Act were also supported. The prescription of full courses of medication and the prescription and administration of electroconvulsive therapy were rejected as nursing roles. University and Trust employed nurses responded differently in a number of these areas. The study concluded that an advanced practice role which incorporates restricted elements of psychiatric practice is supported by psychiatric nurses, and recommends that pilot sites should be established which test the acceptability and effectiveness of the identified role.

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A survey of psychiatric nurses' opinions of advanced practice roles in psychiatric nursing

Allen

1998

Psychiatric Ment Health Nurs

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Neuroleptic Malignant Syndrome Secondary to Metoclopramide Use in an Elderly Gastroenterologic Surgery Patient

Breeden

Ford

Chrisman

et al. 2017

Gastroenterology Nursing

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An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed. She was then transferred to a general medical-surgical unit in a stable condition where she received a total of four 10-mg oral doses of metoclopramide administered every 8 hours. Approximately 32 hours after receiving the first dose of metoclopramide, the patient was subsequently transferred back to the ICU because of fever and inability to maintain respirations. Neuroleptic malignant syndrome was suspected, and the patient was intubated and received supportive care. After a week in the ICU, she was discharged back to the medical-surgical unit in a stable condition and recovered completely. The patient was later discharged home.

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Neuroleptic Malignant Syndrome: A Review

Pelonero¹,

Levenson²,

Pandurangi³

1998

201

162

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Virtually all neuroleptics are capable of inducing the syndrome, including the newer atypical antipsychotics. The standard of care for the recognition of neuroleptic malignant syndrome has shifted considerably over the past 15 years. Neuroleptic malignant syndrome belongs in the differential diagnosis of any patient receiving a neuroleptic who develops a high fever or severe rigidity. In addition to measurement of creatinine phosphokinase and white blood cell count, important tests to rule out other etiologies include urinalysis to measure electrolytes, including calcium and magnesium; kidney, liver, and thyroid function tests; lumbar puncture; an electroencephalogram; and a computed tomography or magnetic resonance imaging scan of the head. Although specific treatment remains controversial, supportive treatment such as antipyretics, a cooling blanket, and intravenous fluids to correct dehydration and electrolyte abnormalities is critical and widely supported by consensus. Most patients recover from neuroleptic malignant syndrome in two to 14 days without any cognitive impairment, and new dysfunction usually is attributable to very high fever, hypoxia, or other complications, rather than neuroleptic malignant syndrome per se.

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NEUROLEPTIC MALIGNANT SYNDROME: Liability in Nursing Practice

Cited by 5 publications

References 28 publications

A survey of psychiatric nurses' opinions of advanced practice roles in psychiatric nursing

A survey of psychiatric nurses' opinions of advanced practice roles in psychiatric nursing

Neuroleptic Malignant Syndrome Secondary to Metoclopramide Use in an Elderly Gastroenterologic Surgery Patient

Neuroleptic Malignant Syndrome: A Review

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