GEORGETTE REVIEW. PMHNP- 388
When many answers are remarkably similar, they are usually
_____________ - CORRECT ANSWERwrong
Interprofessional collaboration is encouraged. - CORRECT
ANSWERCollaborate is usually right.
Delegate is usually wrong.
ADPIER - CORRECT ANSWERAssessment, diagnosis, Plan,
intervention, evaluate, refer out last.
Lithium - CORRECT ANSWERNormal 0.6-1.2
Lithium toxicity occurs at levels - CORRECT ANSWER> 1.5
Signs of Lithium toxicity - CORRECT ANSWERsevere nausea,
diarrhea, vomiting, confusion, drowsiness, muscle weakness,
heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - CORRECT ANSWERMANIA
,Lithium has evidence shown to - CORRECT ANSWERreduce
suicidal ideation
What does lithium cause in neonate, especially 1st trimester -
CORRECT ANSWEREbstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to -
CORRECT ANSWERrise
Baseline labs before initiation of lithium - CORRECT
ANSWERTSH
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 - CORRECT ANSWERhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
,leukocytosis
Pt education for lithimum - CORRECT ANSWERstaying
hydrated
avoiding NSAIDS
compliance
Depakote normal level - CORRECT ANSWER50-125
Depakote toxicity level - CORRECT ANSWERgreater than 150
Teratogenic effects of Depakote - CORRECT ANSWERspina
bifida
Adverse effects of depakote - CORRECT ANSWERalopecia
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 - CORRECT ANSWERdisorientation,
lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity - CORRECT ANSWERDC
med
, check level
LFT
ammonia
MAOI + tyramine causes - CORRECT ANSWERhypertensive
crisis
Symptoms of hypertensive crisis - CORRECT ANSWERelevated
BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - CORRECT
ANSWERMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
When many answers are remarkably similar, they are usually
_____________ - CORRECT ANSWERwrong
Interprofessional collaboration is encouraged. - CORRECT
ANSWERCollaborate is usually right.
Delegate is usually wrong.
ADPIER - CORRECT ANSWERAssessment, diagnosis, Plan,
intervention, evaluate, refer out last.
Lithium - CORRECT ANSWERNormal 0.6-1.2
Lithium toxicity occurs at levels - CORRECT ANSWER> 1.5
Signs of Lithium toxicity - CORRECT ANSWERsevere nausea,
diarrhea, vomiting, confusion, drowsiness, muscle weakness,
heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - CORRECT ANSWERMANIA
,Lithium has evidence shown to - CORRECT ANSWERreduce
suicidal ideation
What does lithium cause in neonate, especially 1st trimester -
CORRECT ANSWEREbstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to -
CORRECT ANSWERrise
Baseline labs before initiation of lithium - CORRECT
ANSWERTSH
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 - CORRECT ANSWERhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
,leukocytosis
Pt education for lithimum - CORRECT ANSWERstaying
hydrated
avoiding NSAIDS
compliance
Depakote normal level - CORRECT ANSWER50-125
Depakote toxicity level - CORRECT ANSWERgreater than 150
Teratogenic effects of Depakote - CORRECT ANSWERspina
bifida
Adverse effects of depakote - CORRECT ANSWERalopecia
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 - CORRECT ANSWERdisorientation,
lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity - CORRECT ANSWERDC
med
, check level
LFT
ammonia
MAOI + tyramine causes - CORRECT ANSWERhypertensive
crisis
Symptoms of hypertensive crisis - CORRECT ANSWERelevated
BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - CORRECT
ANSWERMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
