Manic Monday
Nausea, vomiting, diarrhea, thirst, polyuria, slurred speech, muscle weakness
What are early signs of lithium toxicity?
Poverty of thought, loss of motivation, inability to experience, pleasure or joy, feelings of emptiness, blunted affect
What are negative symptoms of schizophrenia?
Heightened perceptual field, able to work effectively toward goal, slight discomfort, mild tension relieving behavior (foot/finger tapping, chewing, fidgeting)
What is mild level of anxiety?
Do not increase dosage without prior approval, avoid alcohol, avoid drinking caffeinated beverages, may be taken with food to decrease GI discomfort
What are teaching points for taking anxiolytic drugs (benzodiazapines)?
Time frames of symptoms and/or indicated by specific events
•What are the differences in depressive disorders?
–Major Depressive Disorder (2 wks)
–Persistent Depressive Disorder (2 yrs)
–Premenstrual Dysphoric Disorder (specific with menses)
–Postpartum Depression (specific time frame after child birth)
Maintain low level of stimuli in patient environment, provide frequent high-calorie foods, and provide frequent rest periods
What are interventions for acute mania?
Jumoing, netula, confustion
What are examples of neologisms?
Used short term, have quick on-set, use to reduce moderate/severe anxiety
What are benzodiazepines?
Alternative option for medication compliance with a schizophrenic client
What is to use a long-acting IM injection form of medication?
“There’s nothing wrong with me.”- patient has severe chest pain, sweating, pale, and pain down left arm.
What is an example of denial?
Appropriate mood, speech, and dress
What are expected outcomes for bipolar patient?
Silly Sally looks longingly at the wall. Head turned, eyes away avoiding the call. Christmas time is no where near, but in a sing song voice Sally says, “Do you hear what I hear?”
What is clanging?
Greatly reduced perceptual field, focused on details, attention scattered, unable to see connections between events, feelings of dread, confusion
What is severe level of anxiety?
Decreased level of consciousness, greatly increased muscle tone, hyperpyrexia, labile hypertension, tachycardia, diaphoresis
What is Neuroleptic malignant syndrome?
“Of course I failed the test. The teacher never taught us a single thing.”
What is an example of rationalization?
Coarse hand tremors, persistent GI upset, mental confusion, muscle irritability
What are advanced signs of lithium toxicity?
Use this nursing diagnosis for a person experiencing hallucinations
What is Disturbed Sensory Perception: auditory/visual?
Does not cause dependency, useful for GAD, takes 3-4 weeks to see effectiveness
What is buspirone (Buspar)?
May cause high seizure rate, significant weight gain, excessive salivation, agranulocytosis
What is Clozapine (Clozaril)?
Focuses on changing “automatic thoughts” which occur and distort thinking
What is Cognitive Behavioral Therapy? (CBT)
The most effective tool for a patient during a manic phase
What is distractibility/ use of distraction?
Tom said “ I hear my mother’s voice saying terrible things about me.”... best nursing response?
“That must be very upsetting, Tom. Are you feeling upset?”
Unable to focus on environment, may be mute or have extreme psychomotor agitation, dilated pupils, severe shakiness
What is panic level anxiety?
Mixing these meds places patient at higher risk for developing serotonin syndrome
What are SSRIs and MAOIs?
Biological treatment to improve severe depression or treatment resistant bipolar disorder
What is ECT?