Patient Data Review H and P, nurse's notes, and prescriptions. Drag one condition and two nursing actions to complete the sentence. The client is showing signs of _____ and the nurse should plan to _____ and _____ .

• Acute dystonia: The client developed sudden, painful muscle spasms of the neck, back, and tongue with arching of the head shortly after repeated haloperidol doses. These symptoms are classic for an acute dystonic reaction, an extrapyramidal side effect of high-potency antipsychotics. Onset occurs within hours to days of starting or increasing the medication. The sustained muscle contractions and severity of pain strongly support this diagnosis. • Pseudoparkinsonism: Pseudoparkinsonism presents with tremors, shuffling gait, rigidity, and bradykinesia rather than sudden painful spasms. It develops more gradually compared to acute dystonia. The dramatic arching of the head and tongue involvement are more characteristic of dystonia. The client’s acute onset and severe muscle contractions do not align with parkinsons. • Electrolyte imbalance: There is no evidence of laboratory abnormalities, dehydration, or symptoms such as generalized weakness or cardiac irregularities. The temporal relationship to haloperidol administration strongly suggests a medication side effect. Electrolyte imbalances present with broader neuromuscular or cardiac symptoms rather than focal dystonic posturing. • Anaphylaxis: Anaphylaxis would present with hypotension, rash, airway swelling, wheezing, or cardiovascular instability. The client’s symptoms are isolated to muscle spasms without signs of allergic reaction. Vital signs and respiratory findings do not suggest systemic hypersensitivity. The presentation is neurological rather than immunologic. • Akathisia: Akathisia is characterized by inner restlessness and an inability to remain still, not sustained muscle contractions. Clients often pace or report feeling unable to sit quietly. Painful spasms and abnormal posturing are not typical features. The client’s symptoms are clearly dystonic rather than restlessness-based. • Administer diphenhydramine: Diphenhydramine is an anticholinergic agent used to rapidly reverse acute dystonic reactions caused by dopamine blockade. It restores the dopamine-acetylcholine balance in the basal ganglia, relieving muscle rigidity and spasms. Prompt administration reduces pain and prevents progression of symptoms. • Monitor the client's airway: Dystonic reactions can involve the tongue, throat, and laryngeal muscles, potentially compromising the airway. Monitoring ensures early detection of respiratory distress or obstruction. Severe laryngospasm can become life-threatening if not promptly recognized. Close airway assessment is therefore a critical safety priority during acute dystonia. • Give an extra dose of the antipsychotic: Increasing the antipsychotic would likely worsen the extrapyramidal symptoms by further blocking dopamine receptors. This action could intensify muscle rigidity and spasms. Management requires reducing dopamine blockade effects, not increasing them. Continuing the same medication may lead to further complications. • Start the client on magnesium supplements: Magnesium supplementation is used for certain electrolyte deficiencies, not medication-induced dystonia. There is no data indicating hypomagnesemia or other deficiencies. The muscle spasms are linked to dopamine imbalance rather than mineral deficiency. This intervention would not resolve the acute symptoms. • Teach the client about foods with high potassium: Potassium imbalance presents with muscle weakness or cardiac arrhythmias, not focal dystonic contractions. There is no evidence of laboratory abnormalities requiring dietary adjustment. Education about potassium intake does not address the current acute neurological reaction.