LMR GEORGETTE EXAM SCRIPT TESTED
QUESTIONS AND SOLUTIONS
CERTIFICATION EVALUATION
●● 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
QUESTIONS AND SOLUTIONS
CERTIFICATION EVALUATION
●● 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
