Mental Health Pharmacology
SSRIs (e.g., sertraline, fluoxetine) take how long to reach full effect?
4–6 weeks. (Rationale: Delayed onset due to receptor sensitivity changes.)
What is the normal pH range for arterial blood?
7.35–7.45. (Rationale: Below = acidosis; above = alkalosis.)
What formula defines cardiac output?
CO = HR × SV. (Rationale: Heart rate times stroke volume.)
Hold digoxin if the pulse is below __ bpm.
60 bpm. (Rationale: Prevent bradycardia/toxicity.)
Symptoms of hyponatremia?
Confusion, headache, seizures. (Rationale: Brain cell swelling.)
Key patient teaching for SSRIs?
Avoid St. John’s wort and report agitation/confusion. (Rationale: Risk of serotonin syndrome.)
ABG result: pH 7.28, PaCO₂ 55 → what’s the imbalance?
Respiratory acidosis. (Rationale: Retaining CO₂.)
Signs of right-sided heart failure?
Edema, JVD, weight gain. (Rationale: Blood backs up into systemic circulation.)
Adverse effect of ACE inhibitors?
Dry cough. (Rationale: Due to bradykinin accumulation.)
ECG change with hypokalemia?
Flattened or inverted T waves. (Rationale: Low K⁺ affects repolarization.)
Common side effects of benzodiazepines (e.g., lorazepam, alprazolam)?
Sedation, dizziness, dependence. (Rationale: CNS depressant effect.)
Priority teaching for albuterol use?
Use before exercise and for acute wheezing. (Rationale: Rapid-acting bronchodilator.)
The nurse notes a patient has cool extremities, confusion, and oliguria. What’s the likely cause?
Low cardiac output. (Rationale: Decreased perfusion to organs.)
Key safety teaching for beta-blockers?
Do not stop abruptly; monitor HR and BP. (Rationale: Prevent rebound tachycardia.)
First-line treatment for hyperkalemia with ECG changes?
IV calcium gluconate. (Rationale: Stabilizes cardiac membrane.)
What foods must be avoided with MAOIs?
Aged cheese, cured meats, red wine. (Rationale: Risk for hypertensive crisis from tyramine.)
ICS inhaler teaching includes?
Rinse mouth after use. (Rationale: Prevent oral thrush.)
Priority nursing action for chest pain?
Stop activity, apply oxygen, assess vitals. (Rationale: Decrease oxygen demand.)
Nitro teaching — how many doses and how often?
1 tab every 5 min × up to 3 doses. (Rationale: Vasodilates coronary arteries.)
Which client should the nurse assess first?
Asthma patient with silent chest and SpO₂ 88%. (Rationale: Airway obstruction = ABC priority.)
Select all that apply — signs of lithium toxicity.
Vomiting, coarse tremor, confusion, ataxia. (Rationale: Occurs when levels >1.5 mEq/L.)
Select all that apply — anticholinergic adverse effects (ipratropium).
Dry mouth, blurred vision, urinary retention. (Rationale: Inhibits acetylcholine.)
Select all that apply — manifestations of decreased perfusion.
Hypotension, confusion, low urine output, cold skin. (Rationale: Reduced oxygen delivery to tissues.)
Select all that apply — signs of digoxin toxicity.
Bradycardia, nausea, yellow vision changes. (Rationale: Toxicity from increased vagal tone and Na⁺/K⁺ blockade.)
Select all that apply — nursing actions for a patient on warfarin.
Monitor INR, avoid NSAIDs, report bleeding. (Rationale: Prevent hemorrhage complications.)