A 37-year-old client has been taking antipsychotic medication for the past 10 days. The nurse observes her walking with a shuffling gait and postural…

The client is exhibiting signs of drug-induced parkinsonism, an extrapyramidal side effect (EPS) of antipsychotic medications. This condition results from the blockade of dopamine receptors in the nigrostriatal pathway, mimicking idiopathic Parkinson's disease. The classic symptoms include bradykinesia (evidenced by the shuffling gait and masklike facial expression) and rigidity (postural rigidity). The onset of these symptoms within 10 days of starting the medication is typical for this adverse effect.

A. Dystonia is characterized by acute, painful, involuntary muscle spasms and contractions, not the symptoms described.

C. Tardive dyskinesia involves involuntary, repetitive movements and is a late-onset side effect, typically appearing after months or years of therapy.

D. Akathisia is a state of motor restlessness and a subjective feeling of an inability to remain still, which is distinct from the client's presentation.

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). In the section "Medication-Induced Movement Disorders and Other Adverse Effects of Medication," Neuroleptic-Induced Parkinsonism (p. 710) is defined by symptoms including muscular rigidity (e.g., cogwheel rigidity), shuffling gait, and a mask-like face, with onset within a few weeks of initiating a neuroleptic agent.

2. Videbeck, S. L. (2020). Psychiatric-mental health nursing (8th ed.). Wolters Kluwer. In Chapter 2, "Neurobiologic Theories and Psychopharmacology," the text describes pseudoparkinsonism as an extrapyramidal side effect characterized by a stooped posture, masklike facies, and a shuffling gait (p. 36).

3. Divac, N., Prostran, M., Jakovcevski, I., & Cerovac, N. (2014). Second-generation antipsychotics and extrapyramidal adverse effects. BioMed Research International, 2014, 656370. In the "Drug-Induced Parkinsonism (DIP)" section (Section 3.2), the article states that DIP is characterized by "tremor, rigidity, bradykinesia/akinesia, and postural instability." https://doi.org/10.1155/2014/656370