Drugs
Which side effect(s) do NOT belong to SSRI's
Sexual Dysfunction
Feeling like a robot
Stomach Ache
Constipation
Taste Changes
Feeling like a robot
Mental health patients were set free from Asylums like HBH in the 1960's
What was the reason for releasing clients from state hospitals?
Communities were given money by the Federal Gov't to build CMHC and were suppose to see and treat clients in outpatient settings.
You have a client that repeats everything you say to them. What type of speech pattern is this?
Echolalia
What do we think causes bipolar?
Strong genetic link
When do we anticipate SAD to occur?
When days get shorter
October-March
Thomas is an 26-year-old African American transgender male with a history of major depressive disorder (MDD) and suicidal ideation and self-harming behaviors. He arrives to the Emergency Department (ED) per emergency medical services (EMS) for evaluation of suicidal ideation and a recent attempt to harm himself. He became upset this morning following an argument with his roommate and cut himself repeatedly on his left inner thigh using a metal tack. The patient thinks about how it would just be easier to go to sleep and just never wake up. He denies any recent drug or alcohol use. He denies any thoughts of harm to others.
The patient’s legal name is Jenny Thompson. Assigned female at birth, Thomas has identified as a transgender male since age 14. Thomas’ mother died of a drug overdose when Thomas was an infant and has no family that are involved in his life. He was a ward of the state, and his county social worker is his closest support person. He plans to initiate gender-affirming surgery in the future.
Past Medical History:
He has NKDA, no history of chronic illness, UTD with immunizations
The patients priority assessment data indicates:
Disturbed sensory perception
Ineffective coping
Risk for Suicide and non suicidal self injury (NSSI)
Risk for self care deficit
Disturbed thought process
Risk for Suicide and non suicidal self injury (NSSI)
Which drug(s) would you use for a depressed and suicidal client?
Aripiprazole
Clozapine
Clonazepam
Carbamzepine
Fluoxetine
Lithium
Aripiprazole
Fluoxetine AND Lithium
Why does the nurse enter into a contract with a client during their first encounter?
To spell out the responsibilities of both parties.
Why does a client with schizophrenia often have cognitive decline?
Third ventricle enlargement.
What types of medications do we treat bipolar with?
Mood stabilizer
Antipsychotics, typically short term, to induce rest
You are taking care of a client with depression and SI. What three items do you need to find out about the SI?
1. Do they have a plan/what is the plan
2. Have they gathered necessary equipment
3. Have they practiced the method and if so, how far did they get.
* Would eventually set up a safety plan
Thomas is an 26-year-old African American transgender male with a history of major depressive disorder (MDD) and suicidal ideation and self-harming behaviors. He arrives to the Emergency Department (ED) per emergency medical services (EMS) for evaluation of suicidal ideation and a recent attempt to harm himself. He became upset this morning following an argument with his roommate and cut himself repeatedly on his left inner thigh using a metal tack. The patient thinks about how it would just be easier to go to sleep and just never wake up. He denies any recent drug or alcohol use. He denies any thoughts of harm to others.
The patient’s legal name is Jenny Thompson. Assigned female at birth, Thomas has identified as a transgender male since age 14. Thomas’ mother died of a drug overdose when Thomas was an infant and has no family that are involved in his life. He was a ward of the state, and his county social worker is his closest support person. He plans to initiate gender-affirming surgery in the future.
Past Medical History:
He has NKDA, no history of chronic illness, UTD with immunizations
Look at the potential orders and choose if the intervention is essential and needs done NOW. Select all that apply.
Initiate a fluid bolus
Refer for mental health assessment
Urine drug screen
Give oxygen at 2L/nc
Refer for a mental health assessment
Urine drug screen
What drug would you suggest using for treatment resistant schizophrenia?
Clozapine
You are talking to a client and they state "I saw the doctor and the nurse talking out in the hall. They were talking about me being crazy". What type of speech abnormality is this?
Idea of reference
You are talking to a client and they make up words and seamlessly add them to the conversation. What is this called?
Neologism
What type of a mood would you chart for a client that is inpatient, changing their clothes frequently, and very happy to talk with others.
Euphoric
Which medication category(ies) should a depressed person with SI NOT take ?
Tricyclics
Thomas is an 26-year-old African American transgender male with a history of major depressive disorder (MDD) and suicidal ideation and self-harming behaviors. He arrives to the Emergency Department (ED) per emergency medical services (EMS) for evaluation of suicidal ideation and a recent attempt to harm himself. He became upset this morning following an argument with his roommate and cut himself repeatedly on his left inner thigh using a metal tack. The patient thinks about how it would just be easier to go to sleep and just never wake up. He denies any recent drug or alcohol use. He denies any thoughts of harm to others.
The patient’s legal name is Jenny Thompson. Assigned female at birth, Thomas has identified as a transgender male since age 14. Thomas’ mother died of a drug overdose when Thomas was an infant and has no family that are involved in his life. He was a ward of the state, and his county social worker is his closest support person. He plans to initiate gender-affirming surgery in the future.
Past Medical History:
He has NKDA, no history of chronic illness, UTD with immunizations
Limited emotional support
Suicidal ideations
Transgender
Scarring lines on upper arms/inne
Superficial lacerations
African American ethnicity
Major Depressive Disorder
Limited emotional support
Suicidal ideations
Transgender
Scarring lines on upper arms/inne
Superficial lacerations
Major Depressive Disorder
You have an inpatient that is in the manic phase of bipolar, and does not respond to behavioral limit setting.
What drug(s) do you suggest?
Mood stabilizer such as Lithium, valproic acid, carbamazepine, lamotrigine and any psychotropic to rapidly bring them under control, if necessary.
A client you are talking to just started to take a psychotropic. You notice that he is moving his legs constantly. When you ask him about the movement, he says dit just started and is very unpleasant for him. What do we label this movement?
Akathesia
Most people, from time to time, are noncompliant with their medications. What causes a person diagnosed with Schizophrenia to not take their medications?
Anosognosia
You just received your clients lithium level back from the lab. The reading is 1.0 mEq/L
What does this mean?
Therapeutic range 0.8-1.2 mEq/l
Which of the following CAM's may be used for clients suffering with depression.
Vagus Nerve Stimulation
Transcranial Magnetic Stimulation
Exercise
ECT
All could possibly be used
Thomas is an 26-year-old African American transgender male with a history of major depressive disorder (MDD) and suicidal ideation and self-harming behaviors. He arrives to the Emergency Department (ED) per emergency medical services (EMS) for evaluation of suicidal ideation and a recent attempt to harm himself. He became upset this morning following an argument with his roommate and cut himself repeatedly on his left inner thigh using a metal tack. The patient thinks about how it would just be easier to go to sleep and just never wake up. He denies any recent drug or alcohol use. He denies any thoughts of harm to others.
The patient’s legal name is Jenny Thompson. Assigned female at birth, Thomas has identified as a transgender male since age 14. Thomas’ mother died of a drug overdose when Thomas was an infant and has no family that are involved in his life. He was a ward of the state, and his county social worker is his closest support person. He plans to initiate gender-affirming surgery in the future.
Past Medical History:
He has NKDA, no history of chronic illness, UTD with immunizations
Complete the following sentence by ordering the responses by the highest priority.
When assessing for suicide and non suicidal self injury (NSSI) you must:
Educate the patient on coping skills
Develop a therapeutic relationship
Initiate precautions
Assess Risk
Assess Risk
Initiate precautions
Develop a therapeutic relationship
Educate the patient on coping skills
What happens if one switches medications from and SSRI to an MAOI without a 14 day wait period?
Hypertensive Crisis and death
A client you are taking care of is VERY psychotic. You give IM haloperidol q 4 H to help with the psychosis. After 24 hours you go in and check on client VS are slight elevation in BP and T of 101
What do you do ? What do you suspect is happening?
Call HCP STAT
You suspect NMS
A client says to you as you are having a 1:1 conversation "shhhh" and turns their head to the side as if listening to something. What is your best response?
Tell me what you are hearing?
Bipolar clients may have many stages of behavior from low to high and high to low.
Place the following terms place them in order from low to high.
mania
hypomania
euthymia
euthymia
hypomania
mania
You are taking care of a client and you find they really 'connect' with you. The client really likes you and tells you what a great nurse you are especially since you are so young; you really understand what they are going through! This client always wants you to be her nurse. What is the client exhibiting?
Transference
Thomas is an 26-year-old African American transgender male with a history of major depressive disorder (MDD) and suicidal ideation and self-harming behaviors. He arrives to the Emergency Department (ED) per emergency medical services (EMS) for evaluation of suicidal ideation and a recent attempt to harm himself. He became upset this morning following an argument with his roommate and cut himself repeatedly on his left inner thigh using a metal tack. The patient thinks about how it would just be easier to go to sleep and just never wake up. He denies any recent drug or alcohol use. He denies any thoughts of harm to others.
The patient’s legal name is Jenny Thompson. Assigned female at birth, Thomas has identified as a transgender male since age 14. Thomas’ mother died of a drug overdose when Thomas was an infant and has no family that are involved in his life. He was a ward of the state, and his county social worker is his closest support person. He plans to initiate gender-affirming surgery in the future.
Past Medical History:
He has NKDA, no history of chronic illness, UTD with immunizations
The patient is now ready for discharge home. You as the HCW anticipate regression and can to do the following: Select all that apply
Delay the discharge for one day.
Set up aftercare visit to CMHC
Reinforce knowledge learned while in hospital
Review coping skills
Right out safety plan and review with client
Set up aftercare visit to CMHC
Reinforce knowledge learned while in hospital
Review coping skills
Right out safety plan and review with client