NR547 Midterm Exam
5Ps to acquire a customer's sexual records: - ANS-Partners
Practices
Protection from STDs
Past History of STDs
Prevention of Pregnancy
*may recollect including every other P for delight
A fifty two-yr-old purchaser affords to the emergency department following a vehicle accident.
The emergency department (ED) medical doctor is worried that the purchaser may have
deliberately crashed her automobile and requests a stat PMHNP seek advice from. In speakme
with the PMHNP, the customer describes persistent feelings of unhappiness and hopelessness.
She states that she regularly wonders if her husband could be happier if she wasn't round
anymore considering she's in no way satisfied and occasionally thinks about what it would be
like to just take a handful of sound asleep tablets and nod off all the time. The customer reviews
a preceding suicide try whilst she was 16 but denies that she is thinking about killing herself
proper now.
Based on the purchaser's ASQ rating, what's the maximum suitable reaction?
No action is vital because the patron isn't always currently considering suicide.
Provide a short suicide safety evaluation.
Alert the patron's number one care health practitioner.
Provide a ST - ANS-Provide a brief suicide safety assessment.
Rationale: While the purchaser's responses do now not indicate a want for a stat complete
safety and intellectual health assessment, the purchaser calls for a short suicide protection
assessment to determine whether or not a complete intellectual fitness evaluation in vital. It is
also important to notify the customer's physician or the clinician responsible for the consumer's
care.
A consumer has been on clozapine for 9 months. Absolute neutrophil counts (ANC) have
continually been less than 1500/microliter? At what frequency ought to a CBC be drawn?
Every day
weekly
each 2 weeks
monthly - ANS-each 2 weeks
,Rationale: With a regular baseline ANC, the CBC need to be monitored weekly for six months;
each 2 weeks for months 6-12; and monthly thereafter
Adjustment Disorder with Anxiety - ANS-DSM-5 classifies adjustment disease as a trauma- and
stressor-related sickness
-offers with nervousness, worry, or jitteriness
-Adjustment sickness occurs inside the presence of a particular and identifiable stressor
• not unusual stressors include lack of employment, getting married, a brand new incapacity, or
a natural disaster
• Symptoms begin within three months of the stressor and commonly closing no extra than six
months
Agoraphobia - ANS-excessive fear, anxiety, or panic out of proportion to the state of affairs that
happens in two or more of the subsequent particular scenarios:
-public transportation (bus)
-open areas (parking zone or bridge)
-enclosed areas (shop, theater)
-status in a crowd or line (crowd)
-being outdoor of their domestic
alogia - ANS--decrease in speech or speech content material
-symptom of schizophrenia.
-AKA poverty of speech.
American Geriatric Society (AGS) Beers Criteria - ANS-Avoid the usage of haloperidol,
ziprasidone, and olanzapine due to an improved risk of CVA, cognitive decline, and demise in
people with dementia and with dementia-related psychosis.
Anhedonia - ANS-incapacity to revel in pride
anosognosia - ANS-incapability to realize that she or he is unwell, that is resulting from the
contamination itself.
Antipsychotics: Potency low to high - ANS-Chlorpromazine - Low
Mesoridazine - Low
Thioridazine - Low
Thiothixene - Medium
Fluphenazine - Medium
Haloperidol - High
Anxiety Disorders - ANS-Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Panic
,Phobias
Agoraphobia
Adjustment Disorder with Anxiety
Anxiety is frequently comorbid with _________________ in addition to scientific conditions
including ____________, ___________, and ___________ - ANS-important depression, COPD,
allergies, diabetes
Anxiety score scale: GAD-7 - ANS-General Anxiety Disorder-7
-answer query with numerous days (+1), more than 1/2 days (+2), nearly each day (+three)
• Feeling nervous, anxious, or on edge
• Not being able to prevent or control demanding
• Worrying an excessive amount of approximately different things
• Trouble relaxing
• Being so stressed that it's tough to sit down nevertheless
• Becoming effortlessly aggravated or irritable
• Feeling afraid as though something lousy might take place
0-four: No anxiety ailment
5-9: Mild anxiety sickness
10-14: Moderate tension sickness
15-21: Severe anxiety sickness
Anxiety rating scale: HAM-A - ANS-Hamilton Anxiety Scale
-slight (+1), slight (+2), extreme (+three), very excessive (+four)
• Anxious temper
• Tension
• Fears
• Insomnia
• Intellectual
• Depressed mood
• Somatic (muscular)
• Somatic (sensory)
• Cardiovascular signs
• Respiratory symptoms
• Gastrointestinal signs
• Genitourinary symptoms
• Autonomic signs and symptoms
• Behavior at interview
zero-17: Mild tension
18-24: Mild to mild tension
25-30: Moderate to excessive anxiety
31-56: Severe tension
, armodafinil (Nuvigil) - ANS-FDA Indications:
-immoderate sleepiness (OSA, narcolepsy, shift-paintings)
RX Status: Schedule IV
Normal Dosage: 150-250 mg/daily
avolition - ANS-loss of motivation
Basic Laboratory Interpretation - ANS-Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count - ANS--measures RBCs, WBCs,
hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental fitness, the CBC is used to rule out clinical conditions which can gift with signs that
can be attributed to both clinical and psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive signs and symptoms and fatigue
• Ex: rule out infection as a purpose of acute mental status modifications
RBCs: 4.5-6.Zero million/microliter
Hemoglobin: 12-18 grams/one hundred mL
Hematocrit: 38%-forty eight%
Reticulocytes: zero%-1.5%
WBCs (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-three%
Basophils: zero.5%-1%
Lymphocytes: 20%-35%
Monocytes: three%-8%
Platelets: a hundred and fifty,000-300,000/microliter
Basic Laboratory Interpretation: Comprehensive Metabolic Panel (CMP) - ANS-not unusual
blood check used to decide standard health status
-fluid and electrolyte stability, reputation of the frame's metabolism, liver characteristic, and
kidney characteristic
-used to monitor the outcomes of medicines, including antipsychotics, on liver feature and
glucose degrees
5Ps to acquire a customer's sexual records: - ANS-Partners
Practices
Protection from STDs
Past History of STDs
Prevention of Pregnancy
*may recollect including every other P for delight
A fifty two-yr-old purchaser affords to the emergency department following a vehicle accident.
The emergency department (ED) medical doctor is worried that the purchaser may have
deliberately crashed her automobile and requests a stat PMHNP seek advice from. In speakme
with the PMHNP, the customer describes persistent feelings of unhappiness and hopelessness.
She states that she regularly wonders if her husband could be happier if she wasn't round
anymore considering she's in no way satisfied and occasionally thinks about what it would be
like to just take a handful of sound asleep tablets and nod off all the time. The customer reviews
a preceding suicide try whilst she was 16 but denies that she is thinking about killing herself
proper now.
Based on the purchaser's ASQ rating, what's the maximum suitable reaction?
No action is vital because the patron isn't always currently considering suicide.
Provide a short suicide safety evaluation.
Alert the patron's number one care health practitioner.
Provide a ST - ANS-Provide a brief suicide safety assessment.
Rationale: While the purchaser's responses do now not indicate a want for a stat complete
safety and intellectual health assessment, the purchaser calls for a short suicide protection
assessment to determine whether or not a complete intellectual fitness evaluation in vital. It is
also important to notify the customer's physician or the clinician responsible for the consumer's
care.
A consumer has been on clozapine for 9 months. Absolute neutrophil counts (ANC) have
continually been less than 1500/microliter? At what frequency ought to a CBC be drawn?
Every day
weekly
each 2 weeks
monthly - ANS-each 2 weeks
,Rationale: With a regular baseline ANC, the CBC need to be monitored weekly for six months;
each 2 weeks for months 6-12; and monthly thereafter
Adjustment Disorder with Anxiety - ANS-DSM-5 classifies adjustment disease as a trauma- and
stressor-related sickness
-offers with nervousness, worry, or jitteriness
-Adjustment sickness occurs inside the presence of a particular and identifiable stressor
• not unusual stressors include lack of employment, getting married, a brand new incapacity, or
a natural disaster
• Symptoms begin within three months of the stressor and commonly closing no extra than six
months
Agoraphobia - ANS-excessive fear, anxiety, or panic out of proportion to the state of affairs that
happens in two or more of the subsequent particular scenarios:
-public transportation (bus)
-open areas (parking zone or bridge)
-enclosed areas (shop, theater)
-status in a crowd or line (crowd)
-being outdoor of their domestic
alogia - ANS--decrease in speech or speech content material
-symptom of schizophrenia.
-AKA poverty of speech.
American Geriatric Society (AGS) Beers Criteria - ANS-Avoid the usage of haloperidol,
ziprasidone, and olanzapine due to an improved risk of CVA, cognitive decline, and demise in
people with dementia and with dementia-related psychosis.
Anhedonia - ANS-incapacity to revel in pride
anosognosia - ANS-incapability to realize that she or he is unwell, that is resulting from the
contamination itself.
Antipsychotics: Potency low to high - ANS-Chlorpromazine - Low
Mesoridazine - Low
Thioridazine - Low
Thiothixene - Medium
Fluphenazine - Medium
Haloperidol - High
Anxiety Disorders - ANS-Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Panic
,Phobias
Agoraphobia
Adjustment Disorder with Anxiety
Anxiety is frequently comorbid with _________________ in addition to scientific conditions
including ____________, ___________, and ___________ - ANS-important depression, COPD,
allergies, diabetes
Anxiety score scale: GAD-7 - ANS-General Anxiety Disorder-7
-answer query with numerous days (+1), more than 1/2 days (+2), nearly each day (+three)
• Feeling nervous, anxious, or on edge
• Not being able to prevent or control demanding
• Worrying an excessive amount of approximately different things
• Trouble relaxing
• Being so stressed that it's tough to sit down nevertheless
• Becoming effortlessly aggravated or irritable
• Feeling afraid as though something lousy might take place
0-four: No anxiety ailment
5-9: Mild anxiety sickness
10-14: Moderate tension sickness
15-21: Severe anxiety sickness
Anxiety rating scale: HAM-A - ANS-Hamilton Anxiety Scale
-slight (+1), slight (+2), extreme (+three), very excessive (+four)
• Anxious temper
• Tension
• Fears
• Insomnia
• Intellectual
• Depressed mood
• Somatic (muscular)
• Somatic (sensory)
• Cardiovascular signs
• Respiratory symptoms
• Gastrointestinal signs
• Genitourinary symptoms
• Autonomic signs and symptoms
• Behavior at interview
zero-17: Mild tension
18-24: Mild to mild tension
25-30: Moderate to excessive anxiety
31-56: Severe tension
, armodafinil (Nuvigil) - ANS-FDA Indications:
-immoderate sleepiness (OSA, narcolepsy, shift-paintings)
RX Status: Schedule IV
Normal Dosage: 150-250 mg/daily
avolition - ANS-loss of motivation
Basic Laboratory Interpretation - ANS-Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count - ANS--measures RBCs, WBCs,
hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental fitness, the CBC is used to rule out clinical conditions which can gift with signs that
can be attributed to both clinical and psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive signs and symptoms and fatigue
• Ex: rule out infection as a purpose of acute mental status modifications
RBCs: 4.5-6.Zero million/microliter
Hemoglobin: 12-18 grams/one hundred mL
Hematocrit: 38%-forty eight%
Reticulocytes: zero%-1.5%
WBCs (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-three%
Basophils: zero.5%-1%
Lymphocytes: 20%-35%
Monocytes: three%-8%
Platelets: a hundred and fifty,000-300,000/microliter
Basic Laboratory Interpretation: Comprehensive Metabolic Panel (CMP) - ANS-not unusual
blood check used to decide standard health status
-fluid and electrolyte stability, reputation of the frame's metabolism, liver characteristic, and
kidney characteristic
-used to monitor the outcomes of medicines, including antipsychotics, on liver feature and
glucose degrees
