UPDATED QUESTIONS AND CORRECT DETAILED ANSWERS
When many ANSWERs are remarkably similar, they are usually
_____________ - ANSWERwrong
Interprofessional collaboration is encouraged. - ANSWERCollaborate is usually
right.
Delegate is usually wrong.
ADPIER - ANSWERAssessment, diagnosis, Plan, intervention, evaluate, refer
out last.
Lithium - ANSWERNormal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER> 1.5
Signs of Lithium toxicity - ANSWERsevere nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
Lithium is gold standard for - ANSWERMANIA
Lithium has evidence shown to - ANSWERreduce suicidal ideation
,What does lithium cause in neonate, especially 1st trimester -
ANSWEREbstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWERrise
Baseline labs before initiation of lithium - ANSWERTSH
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 - ANSWERhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - ANSWERstaying hydrated
avoiding NSAIDS
compliance
Depakote normal level - ANSWER50-125
,Depakote toxicity level - ANSWERgreater than 150
Teratogenic effects of Depakote - ANSWERspina bifida
Adverse effects of depakote - ANSWERalopecia
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 - ANSWERdisorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - ANSWERDC med
check level
LFT
ammonia
MAOI + tyramine causes - ANSWERhypertensive crisis
Symptoms of hypertensive crisis - ANSWERelevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
, fever
Hypertensive crisis occurs with MAOI + - ANSWERMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - ANSWERDC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - ANSWERfloppy baby, cleft palate
Teratogenic effects of tegratol - ANSWERneural tube defect
teratogenic effects of lithium - ANSWERebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - ANSWERneural tube defects/spina bifida
Adverse reaction to Lamictal - ANSWERSteven Johnson's Syndrome