Georgette Review PMHNP.388
Questions and Complete solutions.
When many answers are remarkably similar, they are usually - ANSWER wrong
Interprofessional collaboration is encouraged. - ANSWER Collaborate is
usually right. Delegate is usually wrong.
ADPIER - ANSWER Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - ANSWER Normal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER > 1.5
Signs of Lithium toxicity - ANSWER severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - ANSWER MANIA
Lithium has evidence shown to - ANSWER reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - ANSWER Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWER rise
Baseline labs before initiation of lithium - 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 - 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 - ANSWER staying
hydrated avoiding NSAIDS
compliance
Depakote normal level - ANSWER 50-125
Depakote toxicity level - ANSWER greater than 150
Teratogenic effects of Depakote - ANSWER spina bifida
Adverse effects of depakote - 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 - ANSWER disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity -
ANSWER DC med check level
LFT
ammonia
MAOI + tyramine causes - ANSWER hypertensive crisis
Symptoms of hypertensive crisis - ANSWER
elevated BP sudden explosive like headache
facial
flushing
palpitations
pupillary
dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - ANSWER
MEPERIDINE STIMULANTS
decongestants
TCAs
atypicals
St. John's
wart L-
tryptophan
asthma
, meds
Treatment for hypertensive crisis - ANSWER DC offending
agent Administer PHENTOLAMINE
Teratogenic effects of benzos - ANSWER floppy baby, cleft palate
Teratogenic effects of tegratol - ANSWER neural tube defect
teratogenic effects of lithium - ANSWER ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - ANSWER neural tube defects/spina bifida
Adverse reaction to Lamictal - ANSWER Steven Johnson's Syndrome
Signs of SJS - ANSWER FEVER --
high yield sore throat
facial
swelling
tongue
swelling red
rash
skin
sloughing
body
aches
prodromal
headache
Questions and Complete solutions.
When many answers are remarkably similar, they are usually - ANSWER wrong
Interprofessional collaboration is encouraged. - ANSWER Collaborate is
usually right. Delegate is usually wrong.
ADPIER - ANSWER Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - ANSWER Normal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER > 1.5
Signs of Lithium toxicity - ANSWER severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - ANSWER MANIA
Lithium has evidence shown to - ANSWER reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - ANSWER Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWER rise
Baseline labs before initiation of lithium - 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 - 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 - ANSWER staying
hydrated avoiding NSAIDS
compliance
Depakote normal level - ANSWER 50-125
Depakote toxicity level - ANSWER greater than 150
Teratogenic effects of Depakote - ANSWER spina bifida
Adverse effects of depakote - 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 - ANSWER disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity -
ANSWER DC med check level
LFT
ammonia
MAOI + tyramine causes - ANSWER hypertensive crisis
Symptoms of hypertensive crisis - ANSWER
elevated BP sudden explosive like headache
facial
flushing
palpitations
pupillary
dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - ANSWER
MEPERIDINE STIMULANTS
decongestants
TCAs
atypicals
St. John's
wart L-
tryptophan
asthma
, meds
Treatment for hypertensive crisis - ANSWER DC offending
agent Administer PHENTOLAMINE
Teratogenic effects of benzos - ANSWER floppy baby, cleft palate
Teratogenic effects of tegratol - ANSWER neural tube defect
teratogenic effects of lithium - ANSWER ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - ANSWER neural tube defects/spina bifida
Adverse reaction to Lamictal - ANSWER Steven Johnson's Syndrome
Signs of SJS - ANSWER FEVER --
high yield sore throat
facial
swelling
tongue
swelling red
rash
skin
sloughing
body
aches
prodromal
headache
