Georgette PMHNP Review Questions and Answers 100% Correct| .

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