Georgette Exam Study Guide Resource - Study Answer Collection

Georgette Exam Study Guide Resource - Study Answer Collection When many answers are remarkably similar, they are usually _____________ - answer - wrong 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 diaphoresis fever Hypertensive crisis occurs with MAOI + - answer - MEPERIDINE STIMULANTS decongestants TCAs atypicals St. John's wart L-tryptophan asthma meds Treatment for hypertensive crisis - answer - DC offending agent Administer PHENTOLAMINE Teratogenic effects of benzos - answer - floppy baby, cleft palate Teratogenic effects of tegratol - answer - neural tube defect teratogenic effects of lithium - answer - ebstein anomaly (heart defect) (avoid, especially 1st trimester) teratogenic effects of depakote - answer - neural tube defects/spina bifida Adverse reaction to Lamictal - answer - Steven Johnson's Syndrome Signs of SJS - answer - FEVER --high yield sore throat facial swelling tongue swelling red rash skin sloughing body aches prodromal headache malaise arthralgia painful mucus membranes Lamotrigine is least likely to cause - answer - sedation or weight gain Carbamazepine (tegretol) black box warning - answer - agranulocytosis (decrease WBCs) aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA) Carbamazepine and asians - answer - Screen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele. Child-bearing aged women - answer - check for pregnancy before starting mood stabilizer start on folic acid to support neural tube development during the first month that a woman is pregnant Clozaril/clozapine can cause - answer - agranulocytosis and neutropenia For monitoring neutropenia in Clozaril, monitor - answer - ANC DC clozarli if ANC - answer - less than 1000 DC clozaril if WBC - answer - , risk of agranulocytosis When on clozaril monitor for - answer - signs and symptoms of infection: sudden fever, chills, sore throat, weakness Clozaril only known antipsychotic to - answer - decrease risk of suicide in patients with schizophrenia. Your patient with bipolar disorder is admitt