substance abuse
difference between tolerance and addiction
tolerance- higher dose is needed due to inadequacy
addiction- physical need for drug
delirium nursing diagnoses
risk for falls, risk for acute confusion, hypovolemia, fear, disturbed sleep pattern, wandering, lack of impulse control
Schizophrenia episodes must last how long for diagnosis
more than 6 months
first generation Medications
high: trifluoperazine, thiothixene, fluphenazine, haloperidol, pirozide
low: Chlorpromazine, thioriadizine
medium: Loxaine, molidone, perphenazine
bipolar I vs bipolar II
bipolar I- hypermania long term, hypomania short term and depression
bipolar II- manic depression more than 2 weeks, hypomania
opioid withdrawal symptoms
tachycardia, N/V/D, hypertension, anxiety, diaphoresis, physical pain, rhinorrhea
4 A's of cognitive impairment
Amnesia, Aphasia, Apraxia, Agnosia
schizoaffective disorder
must have mood disorder as well as schizophrenia (IE bipolar with schizoaffective)
Adverse Reactions to first generation medications
EPS (akathisia, acute dystonia, pseudo parkinsonism)
Tardive Dyskinesia
Neuroleptic Malignant Syndrome (NMS)
S/S of acute mania
euphoria, continuous "high", hallucinations and delusions, excessive motor activity, social and sexual inhibitions, very little need for sleep
Sedative intoxication s/s
slurred speech, incoordination, impaired thinking, unsteady gait
Alzheimer Disease can be genetic (T/F)
True
positive vs negative symptoms
positive: hallucinations, delusions, bizarre behavior (added on)
Negative: blunted affect, poverty of thought (alogia), loss of motivation (avolition), inability to experience pleasure or joy (anhedonia) (taken away)
Second Generation Medications
Aripiprazole (abilify), Clozapine (clozaril), Olanzapine (Zyprexa), Paliperidone (invega), Quetiapine (seroquel), Risperidone (Risperdal), Ziprasidone (geodon)
lithium toxicity s/s, and levels
hand tremors, N/V, weight gain, slurred speech, muscle temors
0.8-1.4
what are the recovery therapies?
Psychotherapy, CBT, group therapy (AA, Al-non, ala-teen) family therapy, residential intensive therapy
all dementia patients are Alzheimer's patients (T/F)
late teens to early 20s
use with antipsychotic drug therapy
antidepressants, lithium and other mood stabilizers, benzodiazepines
Lamitical side effects and adverse reaction
dizziness, shaking, sleepiness, headache, double vision
SJS Stevens-Johnson Syndrome!!!
pharmacotherapy treatment for abstinence for alcohol
Disulfiram (antabuse), Acamprosate (campral), Naltrexone (Revia)
pharmacologic therapy for Alzheimer's
Tacrine (cognex), donepezil (aricept), revastigamine (exelon), galantamine (razadyne)
Schizophrenia can lead to
lengthy hospitalizations, chaos in family life, fear, more costly to people and governments, major risk of suicide
patient education for benzodiazepines
do not operated heavy machinery, do not stop taking abrupt, no alcohol, very addictive
signs of serotonin syndrome
shivering, hyperreflexia, fever, vital sign changes, encephalopathy, restlessness, sweating