Medication Safety
Name two types of selective serotonin reuptake inhibitors
sertraline, citalopram, fluoxetine, escitalopram
What are symptoms of depression
weight loss, poor hygiene, less interest in things, fatigue
What is bipolar?
mood swings from profound depression to extreme euphoria with intervening periods of normalcy
True or False : obsessive compulsive disorder and obsessive compulsive personality are the same thing
FALSE - OCP, they are CHOOSING this behavior or repeated pattern
ECT is most appropriate when:
a) depression is mild
b) patient is refusing to take medications
c) all other treatment options have failed
d) patient is actively manic
c) all other treatment options have failed
What are the side effects of SSRI's
SUICIDE, diarrhea, sexual dysfunction, nausea/vomiting, serotonin syndrome
Name three other types of depressive disorders
Seasonal affective, post partum, persistent depressive, premenstrual dysphoric, substance induced
Name signs and symptoms of mania
rapid speech, unusually optimistic or extremely irritable, reckless, impulsive
What are some characteristics of borderline personality disorder
manipulation, splitting
Teaching for a patient on lithium includes:
a) maintain consistent sodium intake (select all that apply)
b) stay hydrated
c) regular labs
d) fluid restriction
e) stop meds if tremors occur
A, B, C
What education would you give to a patient taking SSRI's?
increased risk of SI, takes 1-3 weeks to take effect, 2-3mo for BEST effect, do not stop meds suddenly
What does anhedonia mean?
inability to feel pleasure
What is the therapeutic range for lithium
0.8 - 1.4
Suicide risk is highest during which phase of depression?
a) during mania
b) when energy begins to return
c) when mood is at the lowest
d) during ECT
b) when energy begins to return - you should worry about a patient that was severely depressed is now energetic, energy levels are high and they may now have the motivation and energy to follow through on their plan
What are some normal side effects of lithium?
Nausea, weight gain, headache, fine hand tremors, polyuria
What types of assessments should the nurse perform for a patient receiving ECT
CONSENT, Neuro, LOC, motor function, efficacy of treatment, vitals, seizure activity
What assessments should a utilize for a manic episode?
history of violence, how long its been going on, frequency of manic episodes, tried medications or whats been effective for them, support system, financial safeguards (protection from themselves)
Bipolar 1 is characterized by:
a) mood swings without mania
b) hypomania
c) depression only
d) full manic episodes
d) full manic episodes
What is the lithium toxicity level range
1.5 - 2
A persistent depressive mood, lasting minimum 2 weeks is called
Major Depressive Disorder
What meds/drug classes might be prescribed for mania?
Anticonvulsants: valproic acid, gabapentin, lamotrigine
Antipsychotics: olanzapine, aripoprazole
Anxiolytics: lorazepam
A patient in the psych unit asks to use their cell phone, which is prohibited, she states "The nurse yesterday let me use my phone whenever I wanted, why are you being so strict"? This is an example of what?
Splitting - attempting to pit staff against each other