Bio basis
This has been called the emotional brain.
What is the limbic system?
This term is used to describe the predictable nature in emotions, which can be sudden and fluctuating.
What is 'labile'
This involves rapid changes often intense in the person's mood, unrelated to the circumstances. The person could have laughing outbursts and then cry shortly after. You may have a conversation with them in the morning of clinical, observe them laughing, and then later they are crying for no apparent reason.
This is the main priority for the patient experiencing a manic episode.
What is remain free from injury?
Antidepressants can cause this symptom change.
What is a manic episode?
Expect these symptoms in cyclothymic disorder.
What is Depressive symptoms that do not meet criteria for a major depressive d/o but causes impairment?
This neurotransmitter is elevated in psychosis and related states
What is dopamine?
This type of thought content involves highly regulated self-regard.
What is grandiosity?
Patients may tell you about their three businesses, that they 'Own this town' or know famous people.
Hyperactivity warrants attention to this basic physiological need.
What is risk for imbalanced nutrition?
Patients with hyperactivity need high-calorie, high-protein food and drink; reminders; and finger foods while 'on the go.'
Combination of these two classes of drugs can lead to this.
What is combining the antidepressants SSRIs/TCAs with MAOIs can lead to a hypertensive crisis?
In a patient taking drugs to inhibit the MAO enzyme (which is what MAOIs do), adding another drug, such as an SSRI, increases the neurotransmitters even more, causing a severely high blood pressure (hypertensive crisis). This is why we avoid using these drugs because there are so many side effects, but will use these when all else fails (treatment refractory depression).
This neurotransmitter is decreased in depressive states.
What is serotonin?
An increase level of this neurotransmitter is seen in Depressive states.
What is prolactin?
This symptom is only present in mania.
What is psychosis?
The patient with hypomania does not exhibit psychosis and is often able to still function at work/school.
Patients taking an antipsychotic may experience this troubling symptom.
What are EPS symptoms?
Bonus question: What medication would likely be administered?
Name a relatively safe alternative to lithium.
What is depakote? Depakote is also an anticonvulsant so could be helpful for those with seizure disorders or migraines. There are serious birth defects that could occur if a women was attempting to conceive.
Depakote is effective for those who refuse lithium and for those who rapid cycle
Name examples of benzodiazepines and note their reasons for use.
What are lorazepam, diazepam, clonazepam, alprazolam?
Anti-anxiety short-term use and alcohol withdrawal.
These two hormones have been implicated in anorexia.
What are abnormal levels of growth hormone and gonadotropin?
This increased motor activity and energy needs to be brought under control for patient safety.
What is hyperactivity?
The nurse notes excessive diarrhea, vomiting, or sweating in the patient taking lithium. What could be the result?
What is lithium toxicity because the lithium levels can rise with fluid shifts?
There are adverse effects of lithium and side effects as with any drug. Name a side effect.
What is weight gain?
Weight gain tends to occur with lithium and other mood stabilizers but this does not warrant discontinuation of the drug, although patients have difficulty with adherence for this reason.
These drugs were widely used before the development of SSRIs.
What are TCAs?
They have more side effects, take longer to reach an optimal therapeutic dose and are far lethal in an overdose. For example, it may take over a month to feel a difference. Also, patients could easily overdose on TCAs.
Selective serotonin reuptake inhibitors (SSRIs) have these desired effects.
What are reducing depression, controlling anxiety, and controlling obsessions?
The initial euphoria (or 'high') of mania typically gives way to this.
What is agitation and irritability?
Utter exhaustion eventually happens and many people collapse into a depression. Note the main symptom for many people with bipolar disorder is irritability.
This discharge instruction is imperative for patient recovery.
What is medication adherence?
Unfortunately, patient often have difficulty accepting their diagnosis and medication adherence will prevent relapse.
This class of drugs should not be used for long because of this.
What are benzos due to their abuse and addictive properties?
This serious side effect of antipsychotics warrants discontinuation.
What is agranulocytosis?
*Learn the signs*
Signs of infection such as fever, chills, soat throat