NURS 660: PSYCHOPHARM / NURS 660: PSYCHOPHARM (Exam 1) QUESTIONS WITH COMPLETE SOLUTIONS

NURS 660: PSYCHOPHARM / NURS 660: PSYCHOPHARM (Exam 1) QUESTIONS WITH COMPLETE SOLUTIONS Minimum ANC level to prescribe Clozapine, general population: - CORRECT ANSWER-1,500 μL Severe Neutropenia - CORRECT ANSWER- 500μL Moderate Neutropenia - CORRECT ANSWER-500-999μL Mild Neutropenia - CORRECT ANSWER-μL BEN patients: Normal ANC range for Clozaril - CORRECT ANSWER-≥1,000 μL Clozaril BEN patient: severe neutropenia - CORRECT ANSWER-500 μL BEN neutropenia - CORRECT ANSWER-500-999 μL Lower ANC threshold for starting clozapine: General population - CORRECT ANSWER-≥1,500/μL Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN) - CORRECT ANSWER-1,000/μL Medical emergencies when prescribing anti-psychotics - CORRECT ANSWER-- NMS - Agranulocytosis - Serotonin Syndrome Clinical findings in agranulocytosis - CORRECT ANSWER- Clozaril: most likely side effect if pt develops fever within 6 weeks - CORRECT ANSWER-Myocarditis Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. - CORRECT ANSWER-EKG, CRP, Troponin, as this is likely due to myocarditis Common complaints in patients with neutropenia: F,P, U, P - CORRECT ANSWER-- Fever (low grade) - painful swallowing (odynophagia) - URI (sinusitis, otitis, cough) - Perirectal pain/irritation Symptoms of neuroleptic malignant syndrome (NMS): - CORRECT ANSWER-- High fever - Tachycardia/irregular pulse - Increased respiratory rate - Muscle Rigidity - altered mental status Off label TX for NMS - CORRECT ANSWER-Amantadine (SYMMETREL) Serotonin Syndrome onset: - CORRECT ANSWER--24 hours of combining antidepressants Serotonin Syndrome Cardinal features - CORRECT ANSWER-- Myoclonic jerks - Hyperreflexia - Mental status changes - Shivering - Fever - Tachycardia, HTN, hypotension (AUTONOMIC instability) - Confused/ restless/ hyperactive/ unresponsive