ANCC Psych Mental Health NP Questions And Answers 2022/2023

What is the lactation risk for Vibrid? - Answer- currently unknown. What warning do all anti-depressants carry? - Answer- Black box warning about suicide Describe an appropriate Fluoxetine taper? - Answer- A taper for Fluoxatine/ Prozac is not needed due to its long half-life (up to 144 hours). It takes about 5 weeks to achieve steady state and will self-taper What is Serotonin Syndrome? - Answer- Toxic levels of serotonin. Can be due to doses of SSRIs (including attempted overdoses), interactions between SSRIs and MAOIs or SSRIs and Tramadol List Serotonin syndrome symptoms? - Answer- These symptoms overlap with Neuroleptic Malignant Syndrome: Elevations in: Blood Pressure, Pulse, Temp, muscle rigidity, drooling, sweating. These symptoms are distinct to Serotonin Syndrome: clonus, agitated confusion, hyper reflexia & bowel sounds; diarrhea Describe Neonatal effects of antidepressants? - Answer- if Mom is on an SSRI baby will have 'discontinuation syndrome' crankiness, irritability for up to a few days What are lactation risk categories? - Answer- L1, safest; L2, safer; L3, moderately safe; L4, possibly hazardous there is positive evidence of risk; L5, contraindicated - significant documented risk. Are there any drugs in the L1 category? - Answer- Acetaminophen ('cause everyone can take tylenol), some of the penicillin (moldy bread; gross but relatively safe), depo-provera (injectable or implantable BC only) What psychiatric drugs are L4 - Answer- Lithium (crosses breast milk), some of the older antipsychotics (so just think 'use SGAs in lactation') Are any drugs in the L5 category? - Answer- Ziprasadone/ Geodon (some question of it being L4), Doxepine /Sinequan (TCA) and cocaine. Fetal exposure to Lithium as been associated with what birth defects? - Answer- 1-polyhydramnios which is excessive amniotic fluid; 2-reversible changes in thyroid function; 3-fetal and neonatal cardiac arrhythmias; 4-hypoglycemia; 5-nephrogenic diabetes insipidus; 6-premature delivery; and 7-floppy inf