Lithium Therapy
Schizophrenia
Who am I?
Nursing Knowledge
100

What labs should be monitored during lithium therapy

Electrolytes (watch for decrease in Na+) thyroid function, routine blood levels to be checked

100

Flat affect, with drawl, difficulty thinking

(loss of function)

What are negative symptoms of schizophrenia?

100

This drug has been associated with severe agranulocytosis, so weekly WBC count tests are scheduled.

What is clozapine?

100

priapism and dry mouth are two possible adverse reactions of which medication?

What is trazadone?

200

What meds are contradicted with lithium

NSAIDs, diuretics( Don't want to pee out that salt)

200

hallucinations, delusions, bizzarre thinking, agitation

(exaggerated function)

What are positive symptoms of schizophrenia?

200

This drug may be used to treat uncontrolled hiccoughs.

What is chlorpromazine?

200

urticaria and photosensitivity are common adverse effects of which type of medication?

What are antipsychotics?

300

What should you teach your patient to include in their diet during lithium therapy

salt

300

Name potential side effects for antipsychotic meds

sedation, hypotension, EPS(extrapyramidal symptoms), NMS(Neuroleptic Malignant syndrome)

300

This drug may be used as an antiemetic.

What is prochlorperazine?

300

The nurse is preparing to administer lorazepam to a client with anxiety.  The nurse anticipates the drug will be given via which route?  Select all that apply.

A. IM
B. ORAL
C. TD
D. IV
E. RECTAL

What is:

A. IM
B. ORAL
D. IV

400

Diarrhea, lethargy, vomiting- early

Other-slurred speech, excessive urination


What are  (EARLY)  symptoms of lithium toxicity?

400

Psuedoparkinsonism, tardive dyskinesia, acute dystonia, akathisia(abnormal face movements) suggest what?

 What extrapyramidal symptoms (EPS)?

400

Antipsychotics take time to produce the optimal effect, sometimes ______ to ______ weeks.

What is 6-10 weeks?

400

The nurse should do what if observed: expressions of guilt, hopelessness, helplessness, indirect threats of suicide, insomnia and/or weight loss.

What is report immediately to the primary care provider?

500

Name some normal side effects you need to teach your patient about lithium

Thirst, Nausea, Tremor, Dizziness

500

This syndrome is a reversible reaction that is a combination of extrapyramidal syndrome, Hyper-rigidity, hyperthermia and autonomic disturbance.

What are symptoms of Neuroleptic Malignant syndrome (NMS)?

500

What class do alprazolam, chlordiazepoxide & lorazepam belong to?

What is benzodiazepines?

500
Ongoing assessment priorities following administration of a sedative-hypnotic therapy that focus on the client's CNS function include?

What is:
Level of alertness (LOC)
Orientation
Ability to perform motor functions

600

A client is receiving lithium. What is an important nursing intervention while this medication is being administered? 

1. Restrict the client’s daily sodium intake. 2. Test the client’s urine specific gravity weekly. 3. Monitor the client’s drug blood level regularly. 4. Withhold the client’s other medications for several days.

3.  Monitor the client’s drug blood level regularly.

600

Client is displaying rhythmic, involuntary facial movements to include chewing like movements and tongue protrusion.  The nurse interprets these findings as an indication of which  irreversible disorder?

What is Tardive Dyskinesia (TD)?

600

Buspirone, doxepin, Meprobamate, and hydroxyzine are considered what class of medication?

What is nonbenzodiazepines?

600

Chest pain, tachycardia, stiff neck, n/v, headache, sweating, fever, dilated pupils and bradycardia or tachycardia are s/s of what SERIOUS adverse reaction when taking MAOIs?

What is hypertensive crisis?

700

A nurse identifies that the client’s lithium blood level is 1.8 mEq/L. What is the most appropriate nursing action? 

1. Continue the usual dose of lithium and note any adverse reactions. 2. Discontinue the drug until the lithium serum level drops to 0.5 mEq/L. 3. Ask the health care provider to increase the dose of lithium because the blood lithium level is too low. 4. Hold the drug and notify the health care provider immediately because the blood lithium level may be toxic.


4. Hold the drug and notify the health care provider immediately because the blood lithium level may be toxic.

700

After administering an antipsychotic agent parenterally, the nurse would ensure that the client remains lying down for which time frame?

What is 30 minutes?

700

Which drug should the nurse anticipate administering for suspected benzodiazepine overdose?

What is flumazenil?

700

Fluid balance determines the concentration of lithium in the blood and thus the client's risk for toxicity. Therefore, ______________ is a priority nursing diagnosis.

What is Dehydration?

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