Georgette Review. PMHNP- 388
QUESTIONS- WITH COMPLETE
SOLUTIONS AND GRADED A PLUS
QUESTIONS AND STRAIGHT ANSWERS
1. When many answers are remarkably similar, they are usually _____________
wrong
2. Interprofessional collaboration is encouraged.
Collaborate is usually right.
Delegate is usually wrong.
3. ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
4. Lithium
Normal 0.6-1.2
5. Lithium toxicity occurs at levels
> 1.5
,6. Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart
palpitation, coarse hand tremors, unsteady gait
7. Lithium is gold standard for
MANIA
8. Lithium has evidence shown to
reduce suicidal ideation
9. What does lithium cause in neonate, especially 1st trimester
Ebstein anomaly (congenital heart defect)
10. dehydration and hyponatremia cause lithium levels to
rise
11. Baseline labs before initiation of lithium
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
*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
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
, Teratogenic effects of Depakote
spina bifida
Adverse effects of depakote
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
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
DC med
check level
LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
QUESTIONS- WITH COMPLETE
SOLUTIONS AND GRADED A PLUS
QUESTIONS AND STRAIGHT ANSWERS
1. When many answers are remarkably similar, they are usually _____________
wrong
2. Interprofessional collaboration is encouraged.
Collaborate is usually right.
Delegate is usually wrong.
3. ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
4. Lithium
Normal 0.6-1.2
5. Lithium toxicity occurs at levels
> 1.5
,6. Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart
palpitation, coarse hand tremors, unsteady gait
7. Lithium is gold standard for
MANIA
8. Lithium has evidence shown to
reduce suicidal ideation
9. What does lithium cause in neonate, especially 1st trimester
Ebstein anomaly (congenital heart defect)
10. dehydration and hyponatremia cause lithium levels to
rise
11. Baseline labs before initiation of lithium
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
*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
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
, Teratogenic effects of Depakote
spina bifida
Adverse effects of depakote
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
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
DC med
check level
LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
