Extrapyramidal Symptoms Induced by Treatment for Delirium: A Case Report

Author(s): Christan D. Santos, MSN, FNP-BC, Mariah Q. Rose, MSN, FNP-BC

Contact Hours 1.00

CERP A 1.00

Pharmacology Hours 0.33

Expires May 26, 2024

Topics: Delirium, Pharmacology

Population: Adult

Role: Staff, APRN

Member: Free
NonMember: $10.00

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Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

Although they are not recommended in clinical practice guidelines for routine treatment of delirium, antipsychotics are used in patients who have associated anxiety or hallucinations or are a danger to themselves or others. Atypical antipsychotics are preferred over first-generation antipsychotics because of their lower incidence of extrapyramidal adverse effects. The most common extrapyramidal sign associated with second-generation antipsychotics is akathisia, which manifests as restlessness, the inability to sit still, and a constant subjective urge to move. This article describes a case of delirium with subsequent atypical antipsychotic–induced akathisia and discuss the critical care nurse’s role in prevention, identification, and management of delirium and extrapyramidal symptoms.


  • Discuss the difference between movement-based symptoms of delirium and extrapyramidal side effects.
  • Identify screening tools used assess ICU patients for signs of delirium.
  • Describe non-modifiable risk factors for delirium.

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity, read Implicit Bias impacts patient outcomes, and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.


The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for 1.00 contact hours.

Accreditation refers to recognition of continuing education only and does not imply AACN, ANCC, or CBRN approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity.


Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content will be identified by the Nurse Planner within the activity. Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content has been mitigated.

AACN programming meets the standards for most states that require mandatory continuing education contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

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