Georgette Review PMHNP. High-Yield Exam Prep
Guide (Psychopharmacology, Neurobiology, DSM-
5, Legal & Ethical Essentials)
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
Guide (Psychopharmacology, Neurobiology, DSM-
5, Legal & Ethical Essentials)
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
