GEORGETTE REVIEW PMHNP.
When many answers are remarkably similar, they are usually
_____________ -CORRECT ANSWER-wrong
Interprofessional collaboration is encouraged. -CORRECT ANSWER-
Collaborate is usually right.
Delegate is usually wrong.
ADPIER -CORRECT ANSWER-Assessment, diagnosis, Plan,
intervention, evaluate, refer out last.
Lithium -CORRECT ANSWER-Normal 0.6-1.2
Lithium toxicity occurs at levels -CORRECT ANSWER-> 1.5
Signs of Lithium toxicity -CORRECT ANSWER-severe nausea, diarrhea,
vomiting, confusion, drowsiness, muscle weakness, heart palpitation,
coarse hand tremors, unsteady gait
Lithium is gold standard for -CORRECT ANSWER-MANIA
Lithium has evidence shown to -CORRECT ANSWER-reduce suicidal
ideation
,What does lithium cause in neonate, especially 1st trimester -
CORRECT ANSWER-Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to -CORRECT
ANSWER-rise
Baseline labs before initiation of lithium -CORRECT ANSWER-TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium -CORRECT ANSWER-hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum -CORRECT ANSWER-staying hydrated
avoiding NSAIDS
compliance
,Depakote normal level -CORRECT ANSWER-50-125
Depakote toxicity level -CORRECT ANSWER-greater than 150
Teratogenic effects of Depakote -CORRECT ANSWER-spina bifida
Adverse effects of depakote -CORRECT ANSWER-alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40,
ALT 5-35, yellowing of skin or eyes, fatigue
Signs of Depakote toxicity -CORRECT ANSWER-disorientation,
lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity -CORRECT ANSWER-DC med
check level
LFT
ammonia
MAOI + tyramine causes -CORRECT ANSWER-hypertensive crisis
Symptoms of hypertensive crisis -CORRECT ANSWER-elevated BP
sudden explosive like headache
facial flushing
, palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + -CORRECT ANSWER-
MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis -CORRECT ANSWER-DC offending
agent
Administer PHENTOLAMINE
Teratogenic effects of benzos -CORRECT ANSWER-floppy baby, cleft
palate
Teratogenic effects of tegratol -CORRECT ANSWER-neural tube defect
When many answers are remarkably similar, they are usually
_____________ -CORRECT ANSWER-wrong
Interprofessional collaboration is encouraged. -CORRECT ANSWER-
Collaborate is usually right.
Delegate is usually wrong.
ADPIER -CORRECT ANSWER-Assessment, diagnosis, Plan,
intervention, evaluate, refer out last.
Lithium -CORRECT ANSWER-Normal 0.6-1.2
Lithium toxicity occurs at levels -CORRECT ANSWER-> 1.5
Signs of Lithium toxicity -CORRECT ANSWER-severe nausea, diarrhea,
vomiting, confusion, drowsiness, muscle weakness, heart palpitation,
coarse hand tremors, unsteady gait
Lithium is gold standard for -CORRECT ANSWER-MANIA
Lithium has evidence shown to -CORRECT ANSWER-reduce suicidal
ideation
,What does lithium cause in neonate, especially 1st trimester -
CORRECT ANSWER-Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to -CORRECT
ANSWER-rise
Baseline labs before initiation of lithium -CORRECT ANSWER-TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium -CORRECT ANSWER-hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum -CORRECT ANSWER-staying hydrated
avoiding NSAIDS
compliance
,Depakote normal level -CORRECT ANSWER-50-125
Depakote toxicity level -CORRECT ANSWER-greater than 150
Teratogenic effects of Depakote -CORRECT ANSWER-spina bifida
Adverse effects of depakote -CORRECT ANSWER-alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40,
ALT 5-35, yellowing of skin or eyes, fatigue
Signs of Depakote toxicity -CORRECT ANSWER-disorientation,
lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity -CORRECT ANSWER-DC med
check level
LFT
ammonia
MAOI + tyramine causes -CORRECT ANSWER-hypertensive crisis
Symptoms of hypertensive crisis -CORRECT ANSWER-elevated BP
sudden explosive like headache
facial flushing
, palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + -CORRECT ANSWER-
MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis -CORRECT ANSWER-DC offending
agent
Administer PHENTOLAMINE
Teratogenic effects of benzos -CORRECT ANSWER-floppy baby, cleft
palate
Teratogenic effects of tegratol -CORRECT ANSWER-neural tube defect
