test 1 medications
Name some of the mood medications such as: SSRIs, SNRIs, mood stabilizers and atypical antipsychotics
SSRI: sertraline, paroxetine, fluoxetine, escitalopram, citalopram
SNRI: venlafaxine, Duloxetine, Desvenlafaxine, Milnacipran, Levomilnacipran "faxine, tine, pran"
Mood: lithium, valproic acid, carbamazepine
Atypical: Quetiapine, Olanzapine, Risperidone, Ariprazole
A alcoholic patient has come into the ER at 1200. At what time might she begin showing signs of withdrawal and what might some of those signs be?
Anywhere from 1600- midnight
shaky, seizure, agitated, headache, High HR/BP, tremors
A patient has come in to start ECT therapy. What medications can we give this person and what are some side effects
Atropine: decrease aspirations, Sulfate: lower secretions, Robenal: lower vegal maneuver 30 minutes before and ibuprofen to lower pain. SE can include: memory loss, HA, N/V
A patient in the behavior center is having a manic episode. What are some things that we can do?
provide finger foods and calm environment, give sleep aid and do not have them involve in competitive games.
A patient has had a spinal cord injury. She has neurogenic shock. What might this look like? She also has autonomic dysreflexia what might this look like?
Low BP and low HR because the vessels are dilated. Red above injury and sweaty and blue below. Give fluids and vasopressors
ADS: 3 bs, raise HOB and then look for 3 bs fix bp if needed and monitor q5minutes.
A patient is taking lithium. What are some teachings for him and signs of toxicity?
Increase sodium intake if you will be losing it. Drink 3L of water a day. If toxic signs can include: polydipsia and polyuria, Diarrhea and vomiting, drowsy and slurred speech, vision. Toxic levels are over 1.4. Labs should be drown Q12 Hour for 1 to 3 days then 12 hours after the last dose. If toxic : hold dose, no signs then monitor and test after 12 Hours
A patient has started disulfiram. What are some teachings that can be included for this patient
Do not drink ANY source of alcohol such as: mouth wash, cough syrup, vanilla extract. Will cause N/V and if so, call HCP immediately.
A patient has tried to commit suicide. Suicidal precautions and physical restraints have been ordered. What are some things we need to know
1:1 , Q15 checks, no ligature risks and give hope.
Restraints should be least invasive first: Doc must reorder Q4H and come in to reorder daily.
A patient has come in from a fire. Upon assessment, there is an entrance and exit wound. What kind of burn might they be experiencing and what are some things we need to do?
electrical burn. put ccollar on and heart monitor.. Monitor UOP: fluid replenish should be 4ml/kg/TBSA and UOP of myoglobin should be 1ml/kg/hr
A patient has ICP. What is a good ICP? what are some non pharm things we can do to help lower. What about pharm? What are 2 major risks and what to do?
0-15. cluster care, stool softener, quiet, no NGT, no pillows, HOB 30-45, no sedatives
give mannitol, furosemide, methylprednisone
SIADH: big- sodium immediately, abx demeclocyline slowly, hold fluid 1l
DI: water! low USG less 1.005 high Na and dehydrated: give fluids and vassopressen
A patient is beginning to take MAOIs. What medications would be contraindicated to take with these medications and why
SSRIs, SNRIs, Warfarin and NSAIDs
can lead to serotonin overload: changes in LOC, sweaty, clammy tremors and rigid muscles.
can lead to excessive bleeding
A EMT walks up to a patient laying on the ground next to a dirty needle. He has RR of 8 breaths per minute. What should the EMT do?
give rescue breaths 1:6, and administer naloxone quickly get them to the hospital
A patient comes in reporting not being able to walk. All tests and labs are drawn and there is no reason for this explanation. His brother comes in and reports that he does this sometimes. What might this patient have and what can we do
Conversion disorder: teaching them that there is nothing medically wrong. Teach coping mechanisms and possibly get into group to help isolation
A patient is on the heart monitor. You walk in and see a sinus brady of 40. Patient has a lower LOC, drowsy and starting to have trouble breathing. What might we do
Atropine 1mg x 3 doses. Then transcutaneous pacing. Possibly apply O2
What are some chemo side effects and what can we do
N/V: promethazine, ondansetrone
stomatitis: mouthcare
Diarrhea: loperimide
Sterility: banking, Anemia: give blood
Alopecia: hats Fatigue: rest/activity
Thrombocytopenia/neutropenia precautions?
A patient is taking carbamazepine. She has come in today reporting unwanted eye and shoulder movements. What might we be able to do for her?
We can contact the HCP on trying to adjust the medications accordingly.
A patient in rehab is 10 days free from heroin. What medications can we begin talking about introducing to the patient?
You are reviewing HIPAA regulations. When might confidentiality be contridicated?
threat, victim, intervene, abuse
A fib is clots- give heparin and pace, possibly adenosine.
Aflutter : vegal down, adenosine, blocker meds and cardiovert
There is a patient with Bipolar Disorder. What are some signs this patient might give and what can we do?
clingy and manipulative. Splitting personality.
change caregivers, set boundaries and rules. Evaluate manipulation signs and determine real/fake
Assess her demeaner and mood. Assess for any means and signs of suicidal ideations. Monitor her frequently.
A alcoholic patient cannot remember any recent events. What might they be experiencing and what can we do?
Korsicoff- give thiamine and Mag
Explain the 4 phases of communication between a nurse and patients
pre: prep, obtain info, self awareness
Orientation: intro with patient, rapport, contract and feelings
Working: problem solve, fix resistance, continue eval
Termination: feelings of end, more coping
Tell me the difference and nursing intervention for Super vena cava syndrome and TLS
SVC: red face, stokes sign, JVD, increased ICP, epistaxis then edema/erythema lower: STENT then HDRT
TLS: killed cells, potassium and uric acid escape. Give fluids 3-5L x 3 days, polystyrene sulfonate, insulin and D50, alloperonal, calcium gluconate (calm heart) and dialysis
what might a person in compensatory shock look like? what is 1 hour bundle of sepsis?
BP normal or low. map 65, HR and RR high. Skin cool and clammy. GI and peripheral pulses are low. lactate over 2 ABGs respiratory alkalosis,
lactate times 2, blood culture 2 places, broad abx, fluid 30ml/kg, meds vassopressors