When many answers are remarkably similar, they are usually _____________ -
ANSWER :
wrong
ADPIER -
ANSWER :
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Interprofessional collaboration is encouraged. -
ANSWER :
Collaborate is usually right.
Delegate is usually wrong.
Lithium -
ANSWER :
Normal 0.6-1.2
Lithium toxicity occurs at levels -
ANSWER :
> 1.5
Signs of Lithium toxicity -
ANSWER :
1
, severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpita-
tion, 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)
2
,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
3
, 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
4
ANSWER :
wrong
ADPIER -
ANSWER :
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Interprofessional collaboration is encouraged. -
ANSWER :
Collaborate is usually right.
Delegate is usually wrong.
Lithium -
ANSWER :
Normal 0.6-1.2
Lithium toxicity occurs at levels -
ANSWER :
> 1.5
Signs of Lithium toxicity -
ANSWER :
1
, severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpita-
tion, 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)
2
,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
3
, 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
4
