The Med Shed
Patients taking this "gold standard" mood stabilizer must maintain consistent salt and fluid intake to avoid toxicity.
What is lithium
For a patient on Lithium, the nurse must notify the provider if the blood level exceeds this specific therapeutic ceiling.
What is 1.5 mEq/L
The nursing priority when a patient on Lamotrigine (Lamictal) reports a new skin rash or blister.
What is immediately notifying the provider (risk of Stevens Johnsons Syndrome)?
This first-generation antipsychotic is highly effective for positive symptoms but carries a high risk for EPS side effects.
What is Haloperidol (Haldol)?
Even if a patient is admitted involuntarily, they still maintain this specific right unless it is an emergency or they are declared incompetent.
What is the Right to Refuse Medication?
This is life-threatening reaction to antipsychotics is characterized by "lead pipe" muscle rigidity, high fever, and autonomic instability.
What is Neuroleptic Malignant Syndrome (NMS)?
This SNRI is often the first-line for both depression and chronic pain, but the nurse must monitor for a "dose-dependent" increase in blood pressure.
What is Duloxetine (Cymbalta)
ATI highlights this "anitcholinergic" effect as a common reason for noncompliance with TCAs (tricyclic antidepressants).
What is urinary retention (or dry mouth/blurred vision)
This permanent EPS side effect involves involuntary movements of the tongue and face, such as lip-smacking or tongue protrusion.
What is Tardive Dyskinesia?
This term describes a nurse's duty to protect a patient from harm and is often used when discussing the least restrictive environment.
What is beneficence?
When switching a patient to an MAOI, they must avoid aged cheese and cured meats to prevent this explosive vascular event.
What is a hypertensive crisis?
When administering Benzodiazepines (like Diazepam) for acute alcohol withdrawal, the nurse's priority assessment is this vital sign.
What is respiratory rate?
When teaching a patient about disulfiram(antabuse) for alcohol use disorder, the nurse must warn them to avoid this "hidden" ingredient in cough syrups and mouthwashes.
what is alcohol?
Second-generation antipsychotics like Risperidone require the nurse to monitor for this "cluster" of weight gain, dyslipidemia, and hyperglycemia.
What is metabolic syndrome?
In an emergency, a nurse can apply restraints without an order, but they must obtain a written prescription from the provider within this time frame.
What is 1 hour? (per the Joint Commission, check your local facility protocol.)
This atypical antipsychotic requires weekly WBC monitoring due to the risk of agranulocytosis.
What is clozapine (clozaril)
Patients starting this antidepressant should be taught that full therapeutic effects can take 4-6 weeks, and to report any "suicidal ideation".
What is an SSRI ( ie, fluoxetine)?
This non-stimulant medication for ADHD does not carry a risk for abuse but does require monitoring for liver injury and suicidal ideation.
What is Atomoxetine (Strattera)?
A patient on Haloperidol with a "locked" neck and upward-deviated eyes is experiencing this acute, medical-emergency EPS.
What is Acute Dystonic Reaction?
This type of admission occurs when a patient is a danger to themselves or others and is typically limited to a 60-day maximum before a legal review.
What is an involuntary admission?
Combining SSRIs with St. Johns Wort can lead to this condition, marked by mental status changes, tremors, and hyperreflexia.
What is serotonin syndrome?
This medication is the preferred treatment for acute dystonic reaction (EPS) caused by haloperidol.
What is diphenhydramine (Benadryl) or Benztropine?
For a patient experiencing an acute panic attack, this class of PRN medication is used for rapid relief, though only for short-term relief.
What are Benzodiazepines (e.g., Lorazepam/Alprazolam)
This specific value must be monitored regularly in patients on Ziprasidone (Geodon) due to the risk of QT prolongation.
What is an EKG (or ECG)?
This ethical principle is violated if a nurse tells a patient that they will give them an extra snack if they take their medication quietly.
What is veracity (or potentially autonomy/coercion)