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GEORGETTE REVIEW PMHNP (CHAMBERLAIN UNIVERSITY) FINAL EXAM TEST PRACTICE QUESTIONS WITH ACCURATE SOLUTIONS- ALREADY GRADED A+

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GEORGETTE REVIEW PMHNP (CHAMBERLAIN UNIVERSITY) FINAL EXAM TEST PRACTICE QUESTIONS WITH ACCURATE SOLUTIONS- ALREADY GRADED A+

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GEORGETTE REVIEW PMHNP (CHAMBERLAIN UNIVERSITY) FINAL EXAM TEST
PRACTICE QUESTIONS WITH ACCURATE SOLUTIONS- ALREADY GRADED A+




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

coase hand tremors with toxicity

maculopapular rash

diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.

anorexia

t wave inversions

leukocytosis




Pt education for lithimum

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

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