NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name

risperidone

Trade Name
Risperdal

Classification
antipsychotics

Dose 1 mg

Route po

Time/frequency q hs

Peak
unknown

Onset
1-2 wk

Duration
up to 6 wk†

For IV meds, compatibility with IV drips and /or solutions

Mechanism of action and indications (Why med ordered)
May act by antagonizing dopamine and serotonin in the CNS Senile dementia

Nursing Implications (what to focus on) Contraindications/warnings/interactions
Geriatric or debilitated patients, patients with renal or hepatic impairment (initial dosage reduction recommended) Geriatric patients (may ↑ cardiovascular morbidity/mortality in elderly patients with dementia-related psychoses) Diabetes or risk factors for diabetes (may worsen glucose control)

Common side effects
aggressive behavior, dizziness, extrapyramidal reactions, headache, increased dreams, increased sleep duration, insomnia, sedation, fatigue, pharyngitis, rhinitis, visual disturbances, cough, constipation, diarrhea, dry mouth, nausea, itching/skin rash, weight gain

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)
↑ CNS depression may occur with other CNS depressants , including, sedative/hypnotics

Lab value alterations caused by medicine
May cause ↑ serum prolactin levels, May cause ↑ AST and ALT, May also cause anemia, thrombocytopenia, leukocytosis, and leukopenia

Be sure to teach the patient the following about this medication
Advise patient to change positions slowly to minimize orthostatic hypotension Advise patient to use sunscreen and protective clothing when exposed to the sun to prevent photosensitivity reactions. Extremes in temperature should also be avoided; this drug impairs body temperature regulation Instruct patient to notify health care professional promptly if sore throat, fever, unusual bleeding or bruising, rash, or tremors occur

Nursing Process- Assessment (Pre-administration assessment)
Monitor patient's mental status (delusions, hallucinations, and behavior) before and periodically during therapy

Assessment Why would you hold or not give this med?
Monitor mood changes. Assess for suicidal tendencies, especially during early therapy. Restrict amount of drug available to patient Monitor blood pressure (sitting, standing, lying down) and pulse before and frequently during initial dose titration. May cause prolonged QT interval, tachycardia, and orthostatic hypotension

Evaluation Check after giving
Decrease in excited, paranoic, or withdrawn behavior Decrease in bipolar mania

Monitor patient for onset of extrapyramidal side effects (akathisia-restlessness; dystonia--muscle spasms and twisting motions; or pseudoparkinsonism--mask-like face, rigidity, tremors, drooling, dysphagia)

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