UPDATED Georgette Review 100% SOLUTION 2023//2024

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 Administer PHENTOLAMINE Teratogenic effects of benzos - ANSWER floppy baby, cleft palate Teratogenic effects of tegratol - ANSWER neural tube defect teratogenic effects of lithium - ANSWER ebstein anomaly (heart defect) (avoid, especially 1st trimester) teratogenic effects of depakote - ANSWER neural tube defects/spina bifida Adverse reaction to Lamictal - ANSWER Steven Johnson's Syndrome Signs of SJS - ANSWER FEVER --high yield sore throat facial swelling tongue swelling red rash skin sloughing body aches prodromal headache malaise arthralgia painful mucus membranes Lamotrigine is least likely to cause - ANSWER sedation or weight gain Carbamazepine (tegretol) black box warning - ANSWER agranulocytosis (decrease WBCs) aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA) Carbamazepine and asians - ANSWER Screen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele. Child-bearing aged women - ANSWER check for pregnancy before starting mood stabilizer start on folic acid to support neural tube development during the first month that a woman is pregnant Clozaril/clozapine can cause - ANSWER agranulocytosis and neutropenia