Antipsychotics
What is metabolic disease (diabetes, hyperlipidemia, obesity)?
Common side effect of atypical antipsychotics that PCPs should monitor
This classification of medications can be dangerous if your patient is exposed to tyramine.
Monoamine Oxidase Inhibitors (MAOIs)
What are valproic acid, carbamazepine, lithium, lamotrigine, and atypical antipsychotics?
3 mood stabilizing agents
Sustained release methylphenidate (Concerta) was administered to a child with ADHD. Which finding best indicates the medication was effective?
Improved ability to participate and focus.
A patient is diagnosed with GAD. What is the preferred anxiolytic to treat this condition?
Buspirone (Buspar)
What patient behaviors would warrant the nurse to administer benztropine?
EPS: Restlessness and muscle rigidity
An overdose of tricyclic antidepressants (TCAs) can result in:
Cardiovascular and neurological toxicity and death.
What is the therapeutic level for lithium?
0.6 to 1.2
The physician mentions to the nurse that a child with ADHD will begin medication therapy. What is the classification of medications are most often used?
Stimulants
A client diagnosed recently with Alzheimer's Disease (AD) is prescribed donepezil (Aricept). How does this medication work?
This medication delays the destruction of acetylcholine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the disease.
After taking chlorpromazine (Thorazine) for 1 month, a patient presents to an ED with severe muscle rigidity, tachycardia, and a temperature of 105oF (40.5°C). Which medical diagnosis and treatment should a nurse anticipate when planning care for this person?
Neuroleptic malignant syndrome treated by discontinuing Thorazine and administering dantrolene (Dantrium)
A nurse assesses a patient in the ED who is experiencing restlessness, tachycardia, diaphoresis, and tremors. She is being treated for depression. Which complication should a nurse suspect, and why?
Serotonin syndrome; possibly caused by ingestion of more than prescribed medication.
The patient, who suffers with bipolar 1 disorder and is on lithium, calls the mental health nurse, stating he is nauseated. To lessen the nausea, the nurse can suggest that the lithium:
Be taken with food
What class of medications is effective in the treatment of Tourette’s disorder?
Neuroleptics
An older widow has recently moved to a nursing home and has trouble concentrating and is socially isolates. A physician believes the widow would benefit from medication therapy. Which medication should the nurse expect the physician to prescribe?
Haloperidol (Haldol); Donepezil (Aricept); Diazepam (Valium); Sertraline (Zoloft)
Sertraline (Zoloft)
What problem, requiring the discontinuation of the medication, is most often associated with taking Clozaril (clozapine)?
Agranulocytosis
Information given to a patient suffering with depression and the family when the patient begins a selective serotonin reuptake inhibitor antidepressant (SSRI) therapy should include:
Increased suicidal thoughts.
To plan care for a patient diagnosed with bipolar type 1 disorder, the nurse must consider that lithium cannot be started until:
The physical examination and laboratory tests are analyzed.
Rationale: Lithium should not be given to clients with impaired renal or thyroid function. A thorough physical examination and various laboratory tests are necessary to rule out other organic causes for the behavior and to ensure that the lithium can be excreted normally
A nurse is teaching an adolescent who recently began atomoxetine for ADHD and his family to be ware of adverse effects that include:
Yellowing skin; Fever; Malaise (hepatoxicity)
A veteran of multiple wars is diagnosed with PTSD and receiving paliperidone (Invega). Which symptoms should a nurse identify that would warrant the need for this medication?
Flashbacks of his buddy getting blown up by a roadside bomb.
A patient and her family meet the nurse in the clinic and complain that the patient is resistant to take her daily dose of a second generation antipsychotic. What might the nurse do in an advocacy role?
Suggest to the healthcare provider to use an antipsychotic decanoate preparation.
A depressed client is receiving imipramine (Tofranil) 300 mg daily. The side effect of this drug for which the nurse should seek medical attention for the client is:
Urinary retention.
What action should the nurse take on learning that a patient's, suffering with bipolar mania, serum lithium level is 1.8 mEq/L?
Withhold medication and notify the physician
CNS depressants like levodopa are often given to child who suffer with:
Conduct disorder to reduce their aggressiveness.
A 48 year old male patient is admitted to your med/surg unit after an auto accident. During your assessment, he tells you that he shares with you that he is on the following medications: Lopressor 50 mg. BID; Risperdal 4 mg. QHS; Lamictal 100 mg. BID; and a daily multivitamin. From his history, you would explore which disease processes with him:
Hypertension and bipolar disorder