Georgette Review PMHNP Accurate Expert
Verified Actual Questions And Correct Answers
For Guaranteed Pass | Latest Update
When many answers are remarkably similar, they are usually
wrong
Interprofessional collaboration is encouraged.
Collaborate is usually right.
Delegate is usually wrong.
ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium
Normal 0.6-1.2
Lithium toxicity occurs at levels
> 1.5
Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse
hand tremors, unsteady gait
,Lithium is gold standard for
MANIA
Lithium has evidence shown to
reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester
Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to
rise
Baseline labs before initiation of lithium
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
hypothyroidism
coarse hand tremors with toxicity
maculopapular rash
,diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithium
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
Teratogenic effects of Depakote
spina bifida
Adverse effects of Depakote
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
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for Depakote toxicity
DC med
check level
LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
MEPERIDINE
STIMULANTS
Verified Actual Questions And Correct Answers
For Guaranteed Pass | Latest Update
When many answers are remarkably similar, they are usually
wrong
Interprofessional collaboration is encouraged.
Collaborate is usually right.
Delegate is usually wrong.
ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium
Normal 0.6-1.2
Lithium toxicity occurs at levels
> 1.5
Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse
hand tremors, unsteady gait
,Lithium is gold standard for
MANIA
Lithium has evidence shown to
reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester
Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to
rise
Baseline labs before initiation of lithium
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
hypothyroidism
coarse hand tremors with toxicity
maculopapular rash
,diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithium
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
Teratogenic effects of Depakote
spina bifida
Adverse effects of Depakote
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
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for Depakote toxicity
DC med
check level
LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
MEPERIDINE
STIMULANTS
