Psychotropics
What medication requires routine monitoring of the ANC lab value?
(Weekly, Biweekly, Monthly)
Clozapine (Clozaril)
What is the difference between ADD and ADHD? And are there different medications for the two?
Hyperactivity vs. attention only
The treatment is the same.
Give at least 3 out of 4 different types of restraints?
What is the general time limit on restraints/Seclusion?
How often should you check the wellbeing, circulation, and airway of the patient in restraints?
Seclusion, Physical, Mechanical, Chemical
No longer than 4 hours
Every 15 minutes
What is the Black Box Warning of Lamotrigine (Lamictal)?
Steven Johnson's Syndrome
You are giving a LAI antipsychotic medication which is 3.9mL's in volume. What is the safest and best evidence based practice muscle to give this volume of medication in?
Ventrogluteal
What medications will you likely see for Alcohol Withdrawal/Detox?
Benzodiazepines and Antiepileptics
What is the difference between Bipolar 1 and Bipolar 2 disorder?
Bipolar 1 includes periods of intense mania followed by periods of depression whereas Bipolar 2 includes periods of hypomania followed by extended periods of persistent depression.
Choose the correct answer; What is a required nursing intervention when giving a patient Lurasidone (Latuda) or Ziprasidone (Geodon)?
a.) The patient must consume roughly 360 calories of food for the med to be absorbed correctly.
b.) The nurse must give the medication only in the evening.
c.) The patient must be instructed to sit upright for 30 minutes following administrations.
d.) These medications are only given IM for emergencies
a.) The patient must consume roughly 360 calories of food for the med to be absorbed correctly.
What are the lab values for mild, moderate, and severe Lithium toxicity?
Mild 1.5-2.5
Moderate 2.5-3.5
Severe >3.5
What is the Black Box Warning on almost every SSRI?
Increase SI in young adults and adolescents.
What are patients taking Wellbutrin at increased risk for?
Seizures
How can you tell the difference between Schizoaffective Disorder and Bipolar 1 disorder?
Psychotic symptoms typically are not present outside of manic events in Bipolar 1 Disorder, whereas psychosis persists even when the mood is not elevated in Schizoaffective disorder.
What does the term "trough level" mean and as nurses how does this term effect your practice?
Trough level is the lowest concentration in a patients blood stream. For nursing, this means you would draw the lab value just prior to the next dosing of the medication.
Describe Ideas of Reference delusions.
False beliefs that random or irrelevant occurrences in the world directly relate to ones self.
What are the leading causes of personality disorders?
Genetics
Childhood trauma/Abuse
What two medications are known to be most effective for suicidal ideation?
Lithium and Clozapine
What assessment can we do to determine the severity of a patients depression?
PHQ-9 (Patient Health Questionnaire-9)
What is an AIMS? And what are we assessing for?
Abnormal Involuntary Movement Scale
Extrapyramidal Symptoms
Outside of depression, what else might your patient be taking antidepressants specifically SSRI's for?
Anxiety (social, separation, generalized)
OCD
Panic Disorder
PTSD
What medications are known to increase instances of mania?
Steroids
Antidepressants
Levodopa
What is the difference between Subutex and Suboxone?
Subutex does not include Naloxone.
What was the intention of adding Naloxone to Suboxone?
What labs would you likely see ordered for a patient who is experiencing Metabolic Syndrome?
CBCd, CMP, Lipids, A1c, Weight/BMI, Waist circumference.
What is acute dystonia? When are you likely to see the symptoms. What meds do you anticipate giving?
Involuntary muscle contractions primarily in the head, neck, larynx, etc. typically from SGA use.
2 weeks typically
Benzo's, muscle relaxant, anticholinergics, Benadryl.
Give 5 things that are included in the MSE outside of Suicidal Ideation and Homicidal Ideation.
Appearance and behavior
Orientation
Mood and Affect
Speech
Thought Process
Insight and judgement
What is EMDR, what is it most often used for, and what is the concept behind its efficacy?
Eye Movement Desensitization and Reprocessing therapy
Trauma
A therapy in which the brain is bilaterally stimulated (typically using eye movements) as a pt. is briefly encouraged to focus on a traumatic event. The concept is that this reduces the vividness and emotion associated with the traumatic memory.