Lithium
Diarrhea, dehydration, sweating, excess exercise in hot weather, diuretic use, and low-sodium diets are all risk factors for this adverse effect of taking lithium.
What is lithium toxicity?
True or false: patients admitted to the psych unit involuntarily do not need to give informed consent for treatments
False: all patients need to give informed consent. Under special circumstances, a medication may be given to sedate a patient chemically.
Delusions, hallucinations, poor judgment, and bizarre behavior all fall under this type of symptom
What are positive symptoms?
Anhedonia, flat affect, anergia, avolition and alogia are all examples of negative symptoms.
True or false: it is appropriate for a nurse to help a depressed patient with grooming
True: helping a patient with grooming (not doing it for them) is a great way to jump-start the patient's desire to take care of themselves.
This is one of the biggest mild concerns for a bipolar patient who is prescribed Zyprexa
What is weight gain?
Bonus: generic name for zyprexa
Know these terms
Regression, agoraphobia, dissociation
This is one of the first signs of serotonin syndrome
What is sweating?
Bonus: what medications besides SSRIs can cause this?
When prescribing valproate the nurse should educate the patient to monitor this blood test.
What is an LFT (liver function test)?
This type of hallucination is a priority for the nurse to address
What is a command hallucination?
A significant weight gain or weight loss should clue the nurse that a patient may be suffering from this mood disorder
What is MDD?
True or false: Bipolar patients will often have nightmares about past traumas
False: nightmares and dreams about past traumas are hallmarks of PTSD (as is anger, isolation, and hypervigilance)
Name 3 types of delusions
Ideas of reference, magical thinking, delusions of grandeur, looseness of association, erotomanic, persecutory
Because Lithium can be harmful to the thyroid this exam should be performed before prescribing and administering lithium.
What is a thyroid hormone assay?
This drug class that treats depression, should be taken at night, not consumed with alcohol, and may cause orthostatic hypotension
What are tricyclic antidepressants?
When a patient believes that the news is referring to his personal life it is considered this type of delusion
What are ideas of reference?
This healthcare worker can help a patient to achieve independence with ADLs
What is an occupational therapist?
True or false: Taking a manic patient on a walk is a good way for a nurse to help manage a manic patient's energy.
True: Clients who have bipolar disorder are prone to hyperactivity. The nurse should provide activities that provide a way for the client to release physical energy, while avoiding situations that might provoke the client. In addition, walking with the nurse provides an opportunity for therapeutic communication.
True or false: Patients who are on lithium should eat a low-sodium diet
False: Patients who are on lithium are at risk for sodium depletion. They should be instructed to eat at least the recommended amounts of sodium (1 mg per 1 calorie daily), drink plenty of water, and avoid vigorous exercise that causes a lot of sweating and dehydration.
When taking clozapine nurses should assess for this very dangerous side effect.
What is agranulocytosis?
This drug class is taken for agitation with schizophrenics and can cause dysrhythmias
What are conventional antipsychotics?
Chlorpromazine, Haloperidol
A nurse should schedule time for a patient diagnosed with this to perform their rituals
What is OCD?
Bonus: how do we mitigate ritualistic behavior?
Recognize that OCD patients have difficulty relaxing, obsess over rules, and perfectionism. We then must identify stress that precipitates these behaviors and try to negate the effects of that stress.
Rapid speech, erratic and compulsive behavior, and hypersexuality should direct the nurse to suspect this
What is mania?
DIGFAST is a way to recall and apply manifestations of manic episodes: delusions, impulsivity, grandiose thoughts, flight of ideas, accelerated speech, sleeplessness, and talkativeness.
Insomnia is a paradoxical effect of this benzodiazepine prescribed for anxiety
What is Xanax?
Bonus: Generic name
Xanax is a good PRN medication for this state of the patient
What is severe anxiety or panic attacks?
Bonus: what is the generic name of Xanax?
Bonus 2: differentiate between panic and delusions
"My charizard gets larigzard when you look at my gleebu" is an example of this alteration in speech
What are neologisms?
Echolalia is repeating or echoing what someone says
Clang association is using words that rhyme
Word salad is using real words in a sequence that doesn't make sense.
What is ECT (electroconvulsive therapy)?
Name three drugs classes that can be used to treat bipolar disorder
What are Mood stabilizers, anticonvulsants, and antipsychotics?
Examples are lithium, Valproate, Carbamazepine, Lamotrigine, Gabapentin, Depakote, Abilify etc.