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 me three interventions for a patient who is having panic.
Take them to a quiet area
Offer PRN medications
Take them on a Walk
Reinforce that they will be ok
What does MSE stand for?
Mental Status Exam
What is PDMP and what is it's purpose?
Prescription Drug Monitoring Program - Monitors the frequency patients are receiving controlled medications to prevent instances of abuse/overuse.
What is a toxic Lithium level?
1.5 or greater
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.
When your cardia patient tells you they are having suicidal ideations, they have a plan to hang themselves with a rope they have at their house, and the intend to hurt themselves when they discharge, what is your nursing intervention?
Do not leave them alone. Call for help. Contact the physician, psychiatrist, or social worker.
What constitutes a flashback, are they always visual, and what assessment is important to include in this nursing documentation documentation?
A vivid experience in which a patient relives some aspect of a traumatic event as if it were happening now.
They can be visual, auditory, olfactory, tangible, ect.
Content, frequency, triggers
Stress hormone
Mental health: Increased anxiety/depression, poor sleep, problems with memory and concentration
Health: Diabetes, Obesity, Cardiovascular Disease, Cancer.
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.
How would you document someones delusions who believes that every number 7 they see in the building is significant to God speaking to them and guiding them to the light?
Ideas of Reference/Religious
Dialectical Behavioral Therapy - which focuses on implementing change in patient behavioral patterns such as self-harming and substance abuse.
What two medications are known to be most effective for suicidal ideation?
Lithium and Clozazpine
What assessment can we do to determine a patients level of depression?
PHQ-9 (Patient Health Questionnaire-9)
What nursing consideration would you have for a patient receiving Adderall on an inpatient unit prior to dosing?
Ensure they have eaten first.
What do you do if your patient becomes agitated after their Adderall dose?
What is the correct way to document a patient who is hearing and seeing things that are "in their head" or that are not real?
"Pt. reports auditory and visual hallucinations. Pt. appears to be responding to internal stimuli with frequent eye movements around the room and speaking to an unk. person/thing throughout assessment. Pt. denies command hallucinations."
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
What do you do for a patient who is experiencing acute dystonia?
Contact your provider, anticipate administration of IV/IM anticholinergics, benzo's, antihistamines, muscle relaxers.
What does S-M-A-R-T stand for?
Specific
Measurable
Actionable
Realistic
Time-Limited
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.