Georgette Review PMHNP.
/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
/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
