Exam 3 pnu 128 UPDATED ACTUAL Exam
Questions and CORRECT Answers
Medication for bipolar disorder - CORRECT ANSWER - Lithium- (anticonvulsant)mood
stabilizer - treats acute mania in BPD
Therapeutic range for lithium is 0.8 meq/L to 1.4 meq/l
Adverse effects-fatigue headache, drowsiness, confusion, muscle weakness, memory
impairment, polyuria.
Nurse intervention: monitor I& O electrolyte imbalance, manifestation of hypothyroidism, such
as lethargy, low heart rate decrease body temperature, need sodium in diet, take with meals,
hydrate
Thyroid function test
Not safe for pregnancy , affects calcium, potassium, magnesium
Valproic Acid (Depakote) - CORRECT ANSWER - Antiseizure med and use for bipolar
mania. Precautions/interactions: contraindicated in liver disease, pregnancy. Side effects:
hepatotoxicity, teratogenic effects, pancreatitis.
* Monitor liver function, serum ammonia levels and platelet and bleeding times. (WBC levels)
Wellbutrin (bupropion) - CORRECT ANSWER - Classification: Antidepressant Smoking
cessation (treats SAD)
Adverse Reactions & side effects: SEIZURES, agitation, HA, dry mouth, nausea, vomiting,
tremor
Nursing Implications & teaching: Monitor mood changes. Assess for suicidal tendencies.
Monitor hepatic and renal function in pts with liver or kidney impairments to prevent increased
serum levels. Don't use in seizure disorder or preeclampsia
bipolar disorder - CORRECT ANSWER - Influenced by genetics and environmental,
psychological factors.
It has two phases-
, manic phase- s/s restlessness, flights of idea grandiosity , hyper mood for judgment,
manipulative behavior, agitation,hallucinations delusion, impulsivity, insomnia, colorful bizarre
attire, poor attention span.SSRI triggers a manic episode
depressive phase-side, low energy level sleep disturbance( too much or too little) high risk for
suicide
Bipolar mania, food choices - CORRECT ANSWER - The nurse should offer high energy
protein dense foods are easily consumed (Finger foods)
Acute Mania Interventions - CORRECT ANSWER - Provide Safety
Limit group activities- no dining room, one on one activities only
Reduce stimuli- quiet environment, turn lights out. Near nurse station
Set limits to manipulative behavior
Finger foods, hydration
Re-channel energy- exercise
Keep away from other pts if they are bothersome
Set limits with consequences for aggression
Promote rest / sleep
Depression treatment - CORRECT ANSWER - Drug Therapy: SSRI-fluoxetine, sertraline,
paroxetine.
TCA-amitriptyline- suicidal ideation 6 weeks full effect. Contraindicated in liver and heart
conditions, don't take with MAOI. Side effects can't pee, poo,spit.
MAOI- phenelzine. side effect *hypertensive crisis urinary retention, insomnia, orthostatic bp.
ECT, Psychotherapy
suicide - CORRECT ANSWER - 2 years after suicide, attempt represent the highest risk
period. especially the first 3 months.
Males are more likely to commit suicide
Questions and CORRECT Answers
Medication for bipolar disorder - CORRECT ANSWER - Lithium- (anticonvulsant)mood
stabilizer - treats acute mania in BPD
Therapeutic range for lithium is 0.8 meq/L to 1.4 meq/l
Adverse effects-fatigue headache, drowsiness, confusion, muscle weakness, memory
impairment, polyuria.
Nurse intervention: monitor I& O electrolyte imbalance, manifestation of hypothyroidism, such
as lethargy, low heart rate decrease body temperature, need sodium in diet, take with meals,
hydrate
Thyroid function test
Not safe for pregnancy , affects calcium, potassium, magnesium
Valproic Acid (Depakote) - CORRECT ANSWER - Antiseizure med and use for bipolar
mania. Precautions/interactions: contraindicated in liver disease, pregnancy. Side effects:
hepatotoxicity, teratogenic effects, pancreatitis.
* Monitor liver function, serum ammonia levels and platelet and bleeding times. (WBC levels)
Wellbutrin (bupropion) - CORRECT ANSWER - Classification: Antidepressant Smoking
cessation (treats SAD)
Adverse Reactions & side effects: SEIZURES, agitation, HA, dry mouth, nausea, vomiting,
tremor
Nursing Implications & teaching: Monitor mood changes. Assess for suicidal tendencies.
Monitor hepatic and renal function in pts with liver or kidney impairments to prevent increased
serum levels. Don't use in seizure disorder or preeclampsia
bipolar disorder - CORRECT ANSWER - Influenced by genetics and environmental,
psychological factors.
It has two phases-
, manic phase- s/s restlessness, flights of idea grandiosity , hyper mood for judgment,
manipulative behavior, agitation,hallucinations delusion, impulsivity, insomnia, colorful bizarre
attire, poor attention span.SSRI triggers a manic episode
depressive phase-side, low energy level sleep disturbance( too much or too little) high risk for
suicide
Bipolar mania, food choices - CORRECT ANSWER - The nurse should offer high energy
protein dense foods are easily consumed (Finger foods)
Acute Mania Interventions - CORRECT ANSWER - Provide Safety
Limit group activities- no dining room, one on one activities only
Reduce stimuli- quiet environment, turn lights out. Near nurse station
Set limits to manipulative behavior
Finger foods, hydration
Re-channel energy- exercise
Keep away from other pts if they are bothersome
Set limits with consequences for aggression
Promote rest / sleep
Depression treatment - CORRECT ANSWER - Drug Therapy: SSRI-fluoxetine, sertraline,
paroxetine.
TCA-amitriptyline- suicidal ideation 6 weeks full effect. Contraindicated in liver and heart
conditions, don't take with MAOI. Side effects can't pee, poo,spit.
MAOI- phenelzine. side effect *hypertensive crisis urinary retention, insomnia, orthostatic bp.
ECT, Psychotherapy
suicide - CORRECT ANSWER - 2 years after suicide, attempt represent the highest risk
period. especially the first 3 months.
Males are more likely to commit suicide
