MISC
What labs should be monitored during lithium therapy
Electrolytes (watch for decrease in Na+) thyroid function, routine blood levels to be checked
What are negative symptoms of schizophrenia
Flat affect, with drawl, difficulty thinking
(loss of function)
What is the pathophysiology of Parkinson's disease
What kind of meds would you give?
decreased dopamine- give dopamine agonist
Increased acetylcholine-
Name some normal side effects you need to teach your patient about lithium
Thirst, Nausea, Tremor, Dizziness
A nurse is providing instructions for a client who is receiving phenytoin but has limited access to health care. What side effect is the basis for the nurse’s emphasis on meticulous oral hygiene?
1. Hyperplasia of the gums 2. Alkalinity of the oral secretions 3. Irritation of the gingiva and destruction of tooth enamel
1
What meds are contradicted with lithium
NSAIDs, diuretics( Don't want to pee out that salt)
Name potential side effects for antipsychotic meds
sedation, hypotension, EPS(extrapyramidal symptoms), NMS(Neuroleptic Malignant syndrome)
Side effects of levodopa-carbidopa and patient teaching points
orthostatic hypotension, rebound symptoms, discolored urine(normal), patient is a fall risk.
Which statements should the nurse rely upon when preparing information to discuss with a client who has been prescribed a CNS depressant/sedative? Select all that apply.
1. Causes a general anesthetic effect with very large doses 2. Produces no hypnotic effect with any dosage 3. Helps relieve anxiety with low doses 4. Reduces excitability 5. Causes insomnia
1,3,4
A nurse is evaluating the medication regimens of a group of clients to determine whether the therapeutic level has been achieved. For which medication should the nurse review the client’s serum blood level?
1. Sertraline 2. Lorazepam 3. Olanzapine 4. Valproic acid
4
What should you teach your patient to include in their diet during lithium therapy
salt
List EPS
Psuedoparkinsonism, tardive dyskinesia, acute dystonia, akathisia(abnormal face movements)
What is the medications given for status epilepticus
Benzodiazepines- lorazepam, diazepam
Which clients have considerations that contraindicate the use of the melatonin agonist, ramelteon? Select all that apply.
1. The woman who is breastfeeding 2. The toddler diagnosed with asthma 3. The man diagnosed with sleep apnea 4. The woman who is 30 weeks pregnant 5. The man diagnosed with cirrhosis of the liver
1,2,3,5
Antipsychotic drugs can cause extrapyramidal side effects. Which responses should the nurse document as indicating pseudoparkinsonism? Select all that apply.
1. Rigidity 2. Tremors 3. Mydriasis 4. Photophobia 5. Bradykinesia
Elsevier. Nursing Key Topics Review: Pharmacology - E-Book (p. 79). Elsevier Health Sciences. Kindle Edition.
1,2,5
Name some symptoms of lithium toxicity (Early)
Diarrhea, lethargy, vomiting- early
Other-slurred speech, excessive urination- see drug book for more
How is EPS prevented
administer lowest does possible, screen after one year, then every three months
Can a patient take phenytoin and warfarin
no
When entering a room on a medical unit, the nurse identifies that a client is having a seizure. What should the nurse do in addition to protecting the client from self-injury?
Monitor the seizure activity.
Elsevier. Nursing Key Topics Review: Pharmacology - E-Book (p. 57). Elsevier Health Sciences. Kindle Edition.
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.
Elsevier. Nursing Key Topics Review: Pharmacology - E-Book (p. 84). Elsevier Health Sciences. Kindle Edition.
3
What are positive symptoms of schizophrenia
hallucinations, delusions, bizzarre thinking, agitation
(exaggerated function)
List symptoms of NMS
Hyper-rigidity, hyperthermia
Side effects of phenytoin
gingival hyperplasia, hyperglycemia, nystagmus, neurotoxicity
A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. The nurse’s best response is “This medication:
1. will probably be continued for life.” 2. prevents the occurrence of seizures.” 3. needs to be taken during periods of emotional stress.” 4. can usually be stopped after a year’s absence of seizures.”
1
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.
Elsevier. Nursing Key Topics Review: Pharmacology - E-Book (p. 84). Elsevier Health Sciences. Kindle Edition.
4