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Patient-Centered Care II > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What med is a non-benzo for long term use pertaining to anxiety?

A

buspirone (Buspar)

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2
Q

What meds are psychostimulants? (3)

A
  1. Methylphenidate (Ritalin)
  2. Lisdexamfetamine (Vivanse)
  3. Methylphenidate (Concerta, Daytrana)
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3
Q

What SNRI treats ADHD?

A

Atomexetine (Strattera)

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4
Q

What meds decrease ETOH cravings? (2)

A
  1. Naltrexone (Trexan)
  2. Topiramate (Topamax)
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5
Q

What med initiates a negative reaction when a pt drinks alcohol in any form?

A

Disulfiram (Antabuse)

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6
Q

What are special considerations for Antabuse?

A

Must sign consent
Must desire to quit

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7
Q

What med is for heroin withdrawal?

A

Methadone

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8
Q

What antipsychotics have a black box warning for suicidal ideation? (2)

A
  1. Aripiprazole (Abilify)
  2. Quetiapine (Seroquel)
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9
Q

What is the black box warning for clozapine (Clozapine)?

A

Can cause agranulocytosis

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10
Q

Which antipsychotic is used during pregnancy?

A

atypical

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11
Q

What antipsychotics are typical? (2)

A
  1. Chlorpromazine (Thorazine)
  2. Haloperidol (Haldol)
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12
Q

What are nursing considerations for Lithium? (5)

A
  1. Administer with food
  2. Administer at bedtime
  3. Toxicity
  4. Watch salt intake
  5. Contraindicated in pregnancy
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13
Q

What is the appropriate serum level for lithium?

A

0.8-1.2 mEq/L

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14
Q

What chemical do benzos enhance?

A

GABA

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15
Q

What chemical do antipsychotics decrease?

A

Dopamine

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16
Q

What chemical does Buspirone enhance?

A

Serotonin

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17
Q

What are side effects of mood stabilizers aka Lithium? (8)

A
  1. fine hand tremors
  2. polyuria
  3. mild thirst
  4. mild nausea
  5. general discomfort
  6. wt gain
  7. slowed thinking
  8. fatigue
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18
Q

What are side effects of lithium toxicity? (6)

A
  1. vomiting
  2. slurred speech
  3. diarrhea
  4. confusion
  5. nystagmus
  6. arrythmias
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19
Q

What labs should be done often when a patient is on lithium?

A

renal
thyroid
drug levels

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20
Q

Typical Antipsychotics treats…

A

positive symptoms of schizophrenia

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21
Q

Typical Antipsychotics can cause…

A

extrapyramidal symptoms

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22
Q

Atypical Antipsychotics treats…

A

positive and negative symptoms of schizophrenia

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23
Q

What are the side effects of atypical antipsychotics?

A

metabolic syndrome:
- wt gain
- dyslipidemia
- insulin resistance

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24
Q

What are the side effects of typical antipsychotics?

A
  1. akathisia (restlessness)
    aka muscle problems
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25
Q

What is tardive dyskinesia?

A

long-term use of antipsychotics can cause involuntary movements of facial muscles, tongue, and limbs

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26
Q

All antipsychotics have which side effects?

A

anticholinergic

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27
Q

What do you use to assess extrapyramidal side effects?

A

AIMS
Abnormal involuntary movement scale

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28
Q

What assessment could the nurse perform to assess for extrapyramidal side effects?

A

feel for cogwheel rigidity in shoulder joints during movement

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29
Q

What medications are used to treat EPS symptoms caused by antipsychotic medications?

A

benadryl
benztropine

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30
Q

How do antiretrovirals for HIV work?

A

-includes at least three medications
-inhibits viral replication or entry into cell

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31
Q

Side effects of antiretrovirals for HIV?

A

flu-like symptoms
skin dryness
rashes
anemia
numbness/tingling
depression
fat redistribution
hepatic/renal failure

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32
Q

Immunomodulators?

A

Interferons
Glatiramer acetate

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33
Q

Immunosupressants?

A

Dimethyl fumarate (Tecfidera)
Mitoxantrone

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34
Q

Side effects of psychostimulants?

A

insomnia, appetite suppression, headache, abdominal pain, lethargy

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35
Q

What are Antiretroviral interactions?

A

PPIs
Antacids
St. John’s Wort

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36
Q

What are nursing considerations for interferons? (2)

A
  1. report depression or SI
  2. photosensitivity
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37
Q

What must be avoided when taking immuno-drugs?

A

rigorous exercise

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38
Q

What medications are used for maintenance of anxiety?

A

SSRI
SSNRI
TCAs

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39
Q

What medications are used for acute anxiety?

A

Benzos
Buspirone

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40
Q

How is the acute phase of schizophrenia directed?

A

Patient safety and medical stabilization

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41
Q

How are the stabilization and maintenance phases of schizophrenia directed?

A

focus on relapse prevention

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42
Q

Warning signs of suicide: “Is path warm”

A

Ideation
Substance Use
Purposelessness
Anxiety
Trapped
Hopelessness
Withdrawal
Anger
Recklessness
Mood Change

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43
Q

4 Behavioral warning signs of suicide

A
  1. giving away possessions
  2. reckless behavior or risk taking
  3. withdrawal from friends and family
  4. increased substance use
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44
Q

What are the 4 screening tools used for mood disorders?

A
  1. Beck
  2. Hamilton
  3. Geriatric Depression
  4. PHQ-9
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45
Q

What is the first line response for bipolar and depression?

A

medication

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46
Q

When is a patient with depression at most risk for suicide?

A

2-3 weeks after starting medication because they start feeling better

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47
Q

How long is the acute phase of MDD?

A

6-12 weeks

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48
Q

What is the first line medication category used for mania?

A

mood stabilizers

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49
Q

What is included in phase 1 of schizophrenia?

A

florid, disruptive symptoms, marked decrease in daily functioning

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50
Q

Treatment of choice for personality disorders?

A

CBT
DON’T MEDICATE

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51
Q

Intervention for BPD

A

DBT

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52
Q

What is the priority of care when working with patients who have personality disorders?

A

safety

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53
Q

What assessment tool is for risk of alcohol dependence?

A

3 & 10 question AUDITS

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54
Q

What score is at risk for alcohol addiction?

A

8-15

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55
Q

What score is at risk for drug addiction?

A

1-2

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56
Q

What is the nursing intervention when the patient is identified as at risk for addiction?

A

brief intervention

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57
Q

What is the nursing intervention when the patient is identified as moderate/high risk for addiction?

A

brief intervention
referral to treatment
behavioral therapy

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58
Q

Alcohol withdrawal symptoms 24-48hr:

A

anxiety
tachycardia
tremors
irritabiltity

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59
Q

Alcohol withdrawal symptoms 48-72hr:

A

delirium

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60
Q

Stimulant (cocaine, amphetamines) withdrawal symptoms:

A

depression
fatigue

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61
Q

Depressant (opiates) withdrawal symptoms:

A

rhinorrhea
insomnia
cramps
panic
chills/fever

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62
Q

What are nursing actions for substance abuse? SBIRT

A

Screening
Brief-
Intervention
Referral to
Treatment

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63
Q

In acute stabilization of substance disorder what is priority?

A

physical needs

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64
Q

What audit score for men is positive?

A

> 4

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65
Q

What audit score for women is positive?

A

> 3

66
Q

What is the most difficult time for quitting?

A

3-6 months after starting

67
Q

What are the nursing actions for the acute phase of grieving?

A

provide presence
(active listening/observing)

68
Q

When is the average age of onset for mood disorders?

A

30s and late 60s

69
Q

What is a risk factor for psychosis?

A

family history

70
Q

What is the average age of onset for anxiety disorders?

A

11

71
Q

Which ethnicity is most at risk for developing anxiety?

A

white

72
Q

What gender is most at risk of committing suicide?

A

men

73
Q

What is the antidote for Anticholinergic Toxicity?

A

physostigmine

74
Q

Serotonin Syndrome symptoms

A

GI upset
Mental Status changes
Autonomic hyperactiivty
Neuromuscular dysfunction

75
Q

What are two clear indications of Serotonin Syndrome?

A

clonus
restlessness

76
Q

Anticholinergic Toxicity symptoms

A

dry as a bone
blind as a bat
red as a beet
hot as hell
mad as a hatter

77
Q

What is a clear indication of Anticholinergic Toxicity?

A

constricted pupils

78
Q

What chemical is low with Neuroleptic Malignant Syndrome?

A

dopamine

79
Q

Neuroleptic Malignant Syndrome symptoms

A

Fever
Autonomic hyperactivity
Rigidity of muscles
Mental Status changes

80
Q

What are two clear indications of Neuroleptic Malignant Syndrome?

A

very high fever
abnormal labs

81
Q

What drugs can cause suicide potential from OD effects causing arrhythmias?

A

TCAs

82
Q

What are 3 considerations with TCAs?

A
  1. take at bedtime
  2. anticholinergic
  3. orthostatic hypotension
83
Q

What injury is often indicative of abuse?

A

abdominal injuries

84
Q

What are 2 suicide assessment tools?

A

SAFE-T
C-SSRS

85
Q

How long does it take for SSRIs to reach full effectiveness?

A

4-6 weeks

86
Q

What is Euthymia?

A

time between manic and depressive episodes

87
Q

What do you administer if spasms severe in serotonin syndrome?

A

cyproheptadine (serotonin blocker)

88
Q

What are the indications for ECT?

A

major depression
acute psychosis

89
Q

What is the difference between a hypomanic episode and a mixed affective episode?

A

mixed includes mania and depression

90
Q

How long must the patient feel depressed before being diagnosed with postpartum depression?

A

4 weeks or longer

91
Q

What are some prodromal symptoms associated with psychosis? (3)

A

odd behavior
social awkwardness
distractibility

92
Q

positive symptoms of schizophrenia

A

add to the person

93
Q

negative symptoms of schizophrenia

A

take away from the person

94
Q

What is included in management of NMS?

A

initiate cooling measures
administer dantrolene/dantrium (muscle relaxant)
administer bromocriptine/parlodel (dopamine agonist)
administer benzo

95
Q

What labs are abnormal with NMS?

A

elevated CK, elevated AST & ALT, elevated WBC

96
Q

What may be used as treatment for catatonia?

A

ECT

97
Q

What is the difference btw schizoid and schizotypal?

A

schizoid doesn’t experience paranoia

98
Q

Histrionic Personality Disorder

A

Has to be the center of attention

99
Q

Assessment findings congruent with borderline personality disorder:

A
  1. separation anxiety
  2. ideas of reference
  3. antagonism
  4. manipulative
  5. splitting defense mechanism
  6. impulsive behaviors (suicide and self-harm)
100
Q

Assessment findings congruent with antisocial personality disorder:

A
  1. “normal” by very charismatic
  2. manipulative
  3. no outward signs of illness
101
Q

FRAMES?

A

Feedback
Responsibility
Advice
Menu of Alternative Change Options
Empathy
Self-Efficacy

102
Q

Interventions for anorexia nervosa?

A
  1. precise mealtimes and adherence to menu
  2. dental consult
  3. refeed: start 1500cal/day then 3500cal/day
  4. restrict/monitor exercise
  5. cover/remove mirrors
103
Q

What medications are often prescribed for anorexia nervosa?

A
  1. multivitamins
  2. calcium supplements
  3. constipation meds
  4. ssri
  5. synthroid
104
Q

Lab values of someone with anorexia nervosa?

A

increased amylase
impaired renal function due to dehydration
low potassium (cardiac dysrhythmias)

105
Q

BMI for anorexia nervosa?

A

<17

106
Q

Symptoms of Chlamydia

A

asymptomatic

107
Q

Treatment for chlamydia

A

antibiotics *doxy

108
Q

When is chlamydia retested after initial treatment?

A

3 months

109
Q

What is the PLISSIT model used for?

A

communicating about sexuality

110
Q

PLISSIT

A

Permission giving
Limited Information
Specific Suggestions
Intensive Therapy

111
Q

What treatments are appropriate for menopause?

A

hormone replacement therapy
Calcium/vit D
SSRI, catapress, neurotin, SERMS
vaginal moisturizers/lubricants

112
Q

When is a combination of hormones used in HRT?

A

when the patient still has a uterus

113
Q

Perimenopause length

A

4 years

114
Q

Perimenopause s/s

A

menstrual irregularities
hot flashes
vaginal dryness
mood symptoms

115
Q

When are you in menopause?

A

no menses 12 months

116
Q

average age of onset of menopause?

A

51.5

117
Q

FSH level indicating menopause?

A

> 30

118
Q

S/S after menopause?

A

osteoporosis
loss of elasticity
increased risk for cardiovascular disease

119
Q

What education is needed for clients with altered sensory function?

A

strict blood glucose monitoring
monitoring alcohol consumption
avoid repetititve movements, exposure to chemicals/toxins, smoking

120
Q

Moist exudative macular degeneration interventions?

A

photodynamic therapy
laser photocoagulation
anti-VEGF therapy

121
Q

Interventions for macular degeneration?

A

antiangiogenic drugs
wear sunglasses
implantable telescope
lucentis, avastin, eylea, macugen

122
Q

What are the signs/symptoms of HF?

A

Tachycardia
Orthopnea
Paroxysmal Nocturnal Dyspnea

123
Q

Potassium-sparing diuretic?

A

spironolactone

124
Q

How do positive inotropes manage HF?

A

increase myocardial contractility

125
Q

Side effects of ACE inhibitors?

A

facial angioedema
renal failure
dry NPC

126
Q

Side effects of ARBs?

A

hypoglycemia
diarrhea
anemia

127
Q

Side effects of beta blockers?

A

bradycardia
bronchospasm

128
Q

Nursing implications for vasodilators?

A

Remove nitrates at night…
Used in acute situations…

129
Q

Nursing implications for positive inotropes?

A

monitor digoxin levels (0.5-2ng/mL)
monitor K and Mg

130
Q

Which laboratory data would indicate the client is experiencing HF?

A

Elevated BNP

131
Q

Vasodilators?

A

nitrates

132
Q

Positive inotropes?

A

dopamine
dobutamine
norepinephrine
milrinone
digoxin

133
Q

ACE inhibitors?

A

-pril

134
Q

ARBs?

A

-sartan

135
Q

Signs of digoxin toxicity

A

vision changes (yellow spots), slow HR, N/V, anorexia

136
Q

s/sx of left sided heart failure

A

SOB
Cyanosis
Pulmonary edema

137
Q

s/sx of right sided heart failure

A

JVD
edema
GI congestion
hepatomegaly, splenomegaly
ascites

138
Q

s/sx of pulmonary edema

A

pink, frothy sputum

139
Q

Risk factors for hyperlipidemia

A

men older than 45
women older than 35

140
Q

Medications for hyperlipidema?

A

HMG-CoA (statins)
bile acid sequestrates
niacin
fibrates
Cholesterol absorption inhibitors
PCSK9 Inhibitors

141
Q

Bile acid sequestrates?

A
  1. cholestyramine (Questran)
  2. colestipol (Colestid)
  3. Colesevelam (Welchol)
142
Q

Fibrates?

A

Gemfibrozil (Lopid)
Fenofibrate (Tricor)

143
Q

Cholesterol Absorption Inhibitors?

A

Ezetimibe (Zetia)

144
Q

PCSK9 inhibitors

A

alirocumab (praluent)
evolovumab (repatha)

145
Q

Hyperlipidemia total cholesterol?

A

<200 mg/dL

146
Q

Hyperlipidemia triglycerides in females?

A

> 135 mg/dL

147
Q

Hyperlipidemia triglycerides in males?

A

> 160 mg/dL

148
Q

Hyperlipidemia LDL?

A

> 130 mg/dL

149
Q

Hyperlipidemia HDL for men

A

<45 mg/dL

150
Q

Hyperlipidemia HDL for women?

A

<55 mg/dL

151
Q

What is average risk ratio for hyperlipidemia?

A

3-5

152
Q

What diagnostic is indicative of HIV/AIDS?

A

CD4+ T cell count

153
Q

Visual symptoms of MS?

A

i. Nystagmus
ii. Diplopia
iii. Blurred vision

154
Q

Speech symptom of MS?

A

dysarthria

155
Q

Sensation symptoms of MS?

A

pain
paresthesia
dizziness
Lhermitte’s sign

156
Q

What education should the nurse give the patient with multiple sclerosis?

A
  • wear sunscreen (photosensitivity)
  • avoid pregnancy
    -avoid hot conditions
  • avoid infection
157
Q

Humoral immunity?

A

B lymph

158
Q

Cell-mediated immunity?

A

T lymph

159
Q

What medications are used to reduce harmful behaviors with those who have autism?

A

risperidone, olanzapine, quetiapine, and aripiprazole to reduce harmful behaviors

160
Q

What are the s/sx of anticholinergic toxicity?

A

Salivation
Lacrimation
Urination
Defecation
Gastric cramping
Emesis
Bradycardia
Bronchorrhea
Bronchospasm

Patient-Centered Care II (7 decks)

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