Exam 2 Flashcards
(20 cards)
Important action for staff members to take with people who have bipolar disorder
Set limits consistently
(They don’t have internal control so they need external control)
Gold standard medication for people who have chronic suicidal thoughts
Lithium
Early signs of lithium toxicity
GI upset
Coarse hand tremor
Confusion
Hyper-irritability of muscles
Electroencephalographic changes
Sedation
Incoordination
Advanced signs of lithium toxicity
Ataxia
Giddiness
Serious electroencephalographic changes
Blurred vision
Clonic movements
Large output of dilute urine
Seizures
Stupor
Severe hypotension
Coma
Death is usually secondary to pulmonary complications
Signs of severe lithium toxicity
Convulsions
Oliguria
Death can occur
Side effects of lithium
Nausea
Vomiting
Diarrhea
Thirst
Polyuria
Lethargy
Sedation
Fine hand tremor
Renal toxicity
Goiter
Hypothyroidism may occur with long-term use
Therapeutic blood level of lithium
0.6 to 1.2 mEq/L
Maintenance blood level of lithium
0.4 to 1.3 mEq/L
Toxic blood level of lithium
1.5 mEq/L and above
When a patient leaves the hospital on lithium, what patient teaching should you do?
- tell pt what it’s for
- explain importance of returning to the clinic for lab draws
- adverse effects
- when they should call the Dr. For adverse effects/toxicity
List the 3 mood stabilizers used for patients with epilepsy
Valproate (Depakote)
Carbamazepine (Equetro)
Lamotrigine (Lamictal)
Side effects of second generation antipsychotics
Tendency toward weight gain that may lead to:
Insulin resistance
Diabetes
Duslipidemia
Cardiovascular impairment
When someone has anxiety, what should they also be screened for?
Bipolar disorder because 75% of people with bipolar also have anxiety
Disorder that tends to be very comorbid and hard to treat
Attention deficit disorder
What should a nurse do if a patient is making them uncomfortable or mad?
Collaborate with other staff
If someone is experiencing fatigue, what side-effect profile do we want to produce? And what is an example of a drug we would give?
Stimulate the CNS
Fluoxetine (SSRI)
If someone is experiencing insomnia what type of side effect profile would we want to give? What is an example of a drug we would give them?
Substantial sedation
Mirtazapine (NaSSAs)
If someone is experiencing sexual dysfunction, what type of side effect profile would we want to give? What is an example of a drug we would give them?
Enhance libido
Bupropion (NDRI)
If someone is in chronic pain, what type of side effect profile would we want to give them? What is an example of a drug we would give them?
Relieve pain
TCAs or duloxetine (SNRI)
What is the worst side effect of antidepressants and why?
Urinary retention because it effects the kidneys
