A client comes into the ED with a skin rash and a sore throat. When
reviewing their chart you notice they are taking Lamotrigine (Lamictal).
What diagnosis is likely to blame? Ans✓✓✓ Steven Johnson syndrome
-rare but can occur while taking this drug
- can also have fever and malaise /
A client who is giving you their specific plan about committing suicide
should have what type of plan of care? Ans✓✓✓ One on one suicide
precautions
A patient who is manic should be placed where in the facility? Ans✓✓✓
Away from the nurses station to provide a calmer, quit environment
Accepting (therapeutic communication) when is it used? Ans✓✓✓
Conveys an attitude of reception and regard
"Yes, I understand what you said."
Eye contact; nodding.
Active vs passive suicide ideations Ans✓✓✓ Active: yes I'm going to
kill my self, I want to die
Passive: well nobody would miss me if I wasn't here
,Affect Ans✓✓✓ Appearance of observable emotions on their face
All antidepressants carry a warning for increased risk of ________ in
children and adolescents Ans✓✓✓ Suicide
Anhedonia Ans✓✓✓ inability to experience pleasure
- sign of depression
Anticonvulsants as mood stabilizers Ans✓✓✓ Carbamazepine
(Tegretol)
Valproic acid (Depakote)
Lamotrigine (Lamictal)
Instructions:
- dont stop abruptly
- report skin rash, unusual bleeding, spontaneous bruising. sore throat,
fever, malaise, dark urine, yellow skin or eyes
- dont use dangerous machinery
- avoid alchol and OTC meds
Side effects:
- dizziness, sedation, constipation
- steven-johnson syndrome (SJS)
-weight gain
,Antidepressants typically take how long to begin working? Ans✓✓✓ 3-
4 weeks for full effect
Improves energy and sleep in 1-2 weeks
Antipsychotics Ans✓✓✓ Aripiprazole (Abilify)
Quetiapine (Seroquel)
Can be used on those with bipolar
Client/ family teaching
- do not stop abruptly
- use sunblock when outside
- rise slowly from a sitting/lying position
- avoid alcohol, smoking and OTC meds
- Continue taking even when feeling better
Assessment of a clients suicide ideation Ans✓✓✓ ▷︎ Identifiy and
distinguish ideas (thoughts), plans (intentions), and attempts (behaviors)
▷︎ distinguish between suicidal self-injury and non suicidal self-injury
▷︎ ask direct question "are you having thoughts of harming yourself"
▷︎ demographics
▷︎ presenting s/s or medical psychiatric diagnosis, or any condition client
is being treated for
, ▷︎ suicidal ideation
▷︎ support system
▷︎ analysis of suicide crisis
▷︎ previous psych treatment
▷︎ coping strategies (what worked in the past)
Assessment rating scales Ans✓✓✓ Zing Self-rating depression scale
Beck depression inventory
Hamilton depression rating scale
Attempting to translate (therapeutic communication) when is it used?
Ans✓✓✓ When feelings are expressed indirectly, the nurse tries to
"desymbolize" what has been said and to find clues to the underlying
true feelings.
Cl: "I'm way out in the ocean."
Ns: "You must be feeling very lonely right now."
Biggest difference between postpartum depression and psychotic
postpartum depression Ans✓✓✓ Postpartum depression: think they cant
take care of their baby
Psychotic postpartum depression: fear they might hurt their baby