ATI MENTAL HEALTH PROCTORED EXAM 2020/2021 Q&A

ATI MENTAL HEALTH PROCTORED EXAM 2020/2021 Q&A Therapeutic uses for tricyclic antidepressants include , neuropathic pain, fibromyalgia, anxiety disorders, insomnia, and bipolar disorder. Depressive disorders Anticholinergic effects of Tricyclic antidepressants dry mouth blurred vision photophobia urinary hesitancy or retention constipation tachycardia Sedation is an adverse effect usually diminishes over time when taking . tricyclic antidepressants (Amitripyline) Advise the client to take at bedtime to minimize daytime sleepiness and to promote sleep. tricyclic antidepressants (amitripyline/Elavil) With give no more than 1 week supply of medication to client who are acutely ill due to the high risk of lethality with overdose. tricyclic antidepressants (Amitripyline) With tricyclic antidepressants (Amitripyline) monitor clients who have a seizure disorder because the seizure is decreased. threshold Clients will have an appetite with tricyclic antidepressants (amitripyline). Instruct the clients to weight weekly and encourage good nutrition/exercise. increased The use of TCAs with alcohol, benzodizepines, opioids, and can result in additive CNS depression. antihistamines SSRIs are a first line treatment for . depression Complications with SSRIs for depression disorders Sexual Dysfunction CNS stimulation: insomnia, agitation, anxiety Weight changes (initial loss then gain) Serotonin syndrome Withdrawal syndrome Hyponatremia esp in older adults on diuretics Rash Sleepiness, faintness, lightheadedness GI bleeding Bruxism esp c citalopram Warn the client of possible sexual dysfunction and to notify the provider if they become intolerable when taking for depression disorders. SSRIs Inform the client that the provider can prescribe an atypical antidepressant instead of SSRIs with fewer sexual dysfunction adverse effects, such as . bupropion. CNS stimulation such as insomnia and agitation can occur when taking for depression. SSRIs Weight loss early in therapy that can be followed by weight gain with long term treatment when taking . SSRIs Discontinue MAOIs 14 days prior to starting an . SSRI (or before having surgery) MAOIs therapeutic uses depression bulimia nervosa first-line treatment for atypical depression MAOIs can cause so monitor blood pressure and HR for orthostatic changes. orthostatic hypotension crisis can occur with MAOIs when there is an intake of dietary tyramine (aged foods, cheeses, fava beans, wine, avocado) hypertensive When taking avoid taking OTC decongestants and cold remedies. MAOIs This class of medications is used PRN for anxiety, but also for ETOH withdrawal, seizures, and as an adjunct for surgery/procedure benzodiazepines ETOH withdrawal: used for acute withdrawal, used for long-term maintenance chlordiazepoxide (Librium) disulfiram (Antabuse) Teaching for disulfiram? avoid all sources of ETOH, including mouthwashes, aftershave, Nyquil, vanilla extract (which seems a little OTT; as if a teaspoon of vanilla divided between 24 cookies and baked is going to do anything, but whatever: so saith ATI) will continue to make you feel like hell for a couple weeks after d/c'ing, so don't think you can skip your dose that day to go party that night, you're going to have to plan ahead to fall off the wagon don't mix benzos with... - other CNS depressants like ETOH (can kill you) - CNS stimulants like caffeine (kinda cancel each other out) benzos that can be administered IV diazepam (Valium) lorazepam (Ativan)