NURS 345 Exam 2 Questions and
Answers
Mental illness ✅psychiatric disorders that have definable diagnoses
Physiological needs ✅food, water, oxygen, sleep, sex, and constant body temperature
Safety needs ✅includes security, protection, freedom from fear, anxiety, and chaos
Belonging and love needs ✅intimate relationships, love, and affection, and belonging;
seek to overcome feelings of loneliness and alienation
Esteem needs ✅-need for having a high self-regard and have it reflected from others
- when these needs are met there is a feeling of being confident, valued, and valuable;
when compromised there are feelings of inferiority, worthlessness, and helplessness
Self actualization ✅-striving to become everything one is capable of becoming
-highly individual
-up to each person to choose a path that will bring about inner peace and fulfillment
Toxicity ✅Patients taking lithium can develop what related to elevated levels in the
blood ?
Daily monitoring ✅Initial therapy of lithium requires what until a safe is therapeutic
level is attained ?
Weekly and monthly monitoring ✅What is recommended for lithium toxicity ?
Decreased sodium levels and inadequate hydration ✅What is lithium toxicity related to
?
Patients must have normal sodium intake and drink at least 2 to 3 L of water daily
✅What should patients taking lithium must have and take ?
Expected side effects of lithium toxicity ✅-nausea, vomiting, diarrhea, polyuria
-renal toxicity
-goiter and hypothyroidism
Early signs of lithium toxicity ✅-GI upset
-coarse hand tremor
-confusion
,-hyperirritability of muscles
-electroencephalographic changes
-sedation
-incoordination
Advanced signs of lithium toxicity ✅-ataxia
-giddiness
-serious electroencephalographic changes
-blurred vision
-clonic movements
-large output of dilute urine
-seizures
-stupor
-severe hypotension
-coma
-death
Side effects of antipsychotics ✅anticholinergic toxicity
Neuroleptic malignant syndrome
Agranulocytosis
Severe signs of lithium toxicity ✅convulsions, oliguria and death
Anticholinergic toxicity ✅life-threatening medical emergency caused by antipsychotics
or other medications with anticholinergic effects including many antiparkinsonian drugs
Neuroleptic malignant syndrome ✅-characterized by reduced consciousness and
responsiveness, increased muscle tone, and autonomic dysfunction
-life-threatening medical emergency
Agranulocytosis ✅associated with clozapine (Clozaril) is possible with other
antipsychotics
Nursing implications for neuroleptic malignant syndrome ✅-early detection
-discontinuation of the antipsychotic
-management of fluid balance
-temperature reduction
-monitoring for complications such as deep vein
-thrombosis and rhabdomyolysis
Acute mania and bipolar maintenance ✅What are anticonvulsants commonly used to
treat ?
Continously cycling patients ✅Who are anticonvulsants generally for ?
, -effective when there is no family history of bipolar disease
-effective at diminishing impulsive and aggressive behavior in some nonpsychotic
patients ✅When are anticonvulsants effective ?
Helpful in cases of alcohol and benzodiazepine withdrawal ✅When are antipsychotics
helpful?
Controlling mania (within 2 weeks) and depression (within 3 weeks or longer) ✅When
are antipsychotics beneficial?
Valproate ✅treats acute mania and prevents future manic episodes
Lamotrigine ✅can cause life threatening rash
Symptoms of serotonin syndrome ✅abdominal pain, diarrhea, sweating, fever,
tachycardia, elevated blood pressure, altered mental state (delirium), myoclonus
(muscle spams), increased motor activity, irritability, hostility, and mood change
Hyperpyrexia (excessively high fever), cardiovascular shock or death ✅Severe
manifestations of serotonin syndrome can lead to what ?
Signs and symptoms of SSR/NDRI (serotonin syndrome) ✅-hyperactivity or
restlessness
-tachycardia ----> cardiovascular shock
-fever ----> hyperpyrexia
-elevated blood pressure
-altered mental status (delirium)
-irrationality
-mood swings
-hostility
-seizures
-myoclonus (muscle spasms)
-incoordination
-tonic rigidity
-abdominal pain
-diarrhea
-bloating
-apnea ---> death
Silence ✅gives the person time to collect thoughts or think through a point
Example: encouraging a person to talk by waiting for the answers
Interventions of SSR/NDRI (serotonin syndrome) ✅-removing offending agent
Answers
Mental illness ✅psychiatric disorders that have definable diagnoses
Physiological needs ✅food, water, oxygen, sleep, sex, and constant body temperature
Safety needs ✅includes security, protection, freedom from fear, anxiety, and chaos
Belonging and love needs ✅intimate relationships, love, and affection, and belonging;
seek to overcome feelings of loneliness and alienation
Esteem needs ✅-need for having a high self-regard and have it reflected from others
- when these needs are met there is a feeling of being confident, valued, and valuable;
when compromised there are feelings of inferiority, worthlessness, and helplessness
Self actualization ✅-striving to become everything one is capable of becoming
-highly individual
-up to each person to choose a path that will bring about inner peace and fulfillment
Toxicity ✅Patients taking lithium can develop what related to elevated levels in the
blood ?
Daily monitoring ✅Initial therapy of lithium requires what until a safe is therapeutic
level is attained ?
Weekly and monthly monitoring ✅What is recommended for lithium toxicity ?
Decreased sodium levels and inadequate hydration ✅What is lithium toxicity related to
?
Patients must have normal sodium intake and drink at least 2 to 3 L of water daily
✅What should patients taking lithium must have and take ?
Expected side effects of lithium toxicity ✅-nausea, vomiting, diarrhea, polyuria
-renal toxicity
-goiter and hypothyroidism
Early signs of lithium toxicity ✅-GI upset
-coarse hand tremor
-confusion
,-hyperirritability of muscles
-electroencephalographic changes
-sedation
-incoordination
Advanced signs of lithium toxicity ✅-ataxia
-giddiness
-serious electroencephalographic changes
-blurred vision
-clonic movements
-large output of dilute urine
-seizures
-stupor
-severe hypotension
-coma
-death
Side effects of antipsychotics ✅anticholinergic toxicity
Neuroleptic malignant syndrome
Agranulocytosis
Severe signs of lithium toxicity ✅convulsions, oliguria and death
Anticholinergic toxicity ✅life-threatening medical emergency caused by antipsychotics
or other medications with anticholinergic effects including many antiparkinsonian drugs
Neuroleptic malignant syndrome ✅-characterized by reduced consciousness and
responsiveness, increased muscle tone, and autonomic dysfunction
-life-threatening medical emergency
Agranulocytosis ✅associated with clozapine (Clozaril) is possible with other
antipsychotics
Nursing implications for neuroleptic malignant syndrome ✅-early detection
-discontinuation of the antipsychotic
-management of fluid balance
-temperature reduction
-monitoring for complications such as deep vein
-thrombosis and rhabdomyolysis
Acute mania and bipolar maintenance ✅What are anticonvulsants commonly used to
treat ?
Continously cycling patients ✅Who are anticonvulsants generally for ?
, -effective when there is no family history of bipolar disease
-effective at diminishing impulsive and aggressive behavior in some nonpsychotic
patients ✅When are anticonvulsants effective ?
Helpful in cases of alcohol and benzodiazepine withdrawal ✅When are antipsychotics
helpful?
Controlling mania (within 2 weeks) and depression (within 3 weeks or longer) ✅When
are antipsychotics beneficial?
Valproate ✅treats acute mania and prevents future manic episodes
Lamotrigine ✅can cause life threatening rash
Symptoms of serotonin syndrome ✅abdominal pain, diarrhea, sweating, fever,
tachycardia, elevated blood pressure, altered mental state (delirium), myoclonus
(muscle spams), increased motor activity, irritability, hostility, and mood change
Hyperpyrexia (excessively high fever), cardiovascular shock or death ✅Severe
manifestations of serotonin syndrome can lead to what ?
Signs and symptoms of SSR/NDRI (serotonin syndrome) ✅-hyperactivity or
restlessness
-tachycardia ----> cardiovascular shock
-fever ----> hyperpyrexia
-elevated blood pressure
-altered mental status (delirium)
-irrationality
-mood swings
-hostility
-seizures
-myoclonus (muscle spasms)
-incoordination
-tonic rigidity
-abdominal pain
-diarrhea
-bloating
-apnea ---> death
Silence ✅gives the person time to collect thoughts or think through a point
Example: encouraging a person to talk by waiting for the answers
Interventions of SSR/NDRI (serotonin syndrome) ✅-removing offending agent
