Final Exam Flashcards
1
Q
What med is a non-benzo for long term use pertaining to anxiety?
A
buspirone (Buspar)
2
Q
What meds are psychostimulants? (3)
A
- Methylphenidate (Ritalin)
- Lisdexamfetamine (Vivanse)
- Methylphenidate (Concerta, Daytrana)
3
Q
What SNRI treats ADHD?
A
Atomexetine (Strattera)
4
Q
What meds decrease ETOH cravings? (2)
A
- Naltrexone (Trexan)
- Topiramate (Topamax)
5
Q
What med initiates a negative reaction when a pt drinks alcohol in any form?
A
Disulfiram (Antabuse)
6
Q
What are special considerations for Antabuse?
A
Must sign consent
Must desire to quit
7
Q
What med is for heroin withdrawal?
A
Methadone
8
Q
What antipsychotics have a black box warning for suicidal ideation? (2)
A
- Aripiprazole (Abilify)
- Quetiapine (Seroquel)
9
Q
What is the black box warning for clozapine (Clozapine)?
A
Can cause agranulocytosis
10
Q
Which antipsychotic is used during pregnancy?
A
atypical
11
Q
What antipsychotics are typical? (2)
A
- Chlorpromazine (Thorazine)
- Haloperidol (Haldol)
12
Q
What are nursing considerations for Lithium? (5)
A
- Administer with food
- Administer at bedtime
- Toxicity
- Watch salt intake
- Contraindicated in pregnancy
13
Q
What is the appropriate serum level for lithium?
A
0.8-1.2 mEq/L
14
Q
What chemical do benzos enhance?
A
GABA
15
Q
What chemical do antipsychotics decrease?
A
Dopamine
16
Q
What chemical does Buspirone enhance?
A
Serotonin
17
Q
What are side effects of mood stabilizers aka Lithium? (8)
A
- fine hand tremors
- polyuria
- mild thirst
- mild nausea
- general discomfort
- wt gain
- slowed thinking
- fatigue
18
Q
What are side effects of lithium toxicity? (6)
A
- vomiting
- slurred speech
- diarrhea
- confusion
- nystagmus
- arrythmias
19
Q
What labs should be done often when a patient is on lithium?
A
renal
thyroid
drug levels
20
Q
Typical Antipsychotics treats…
A
positive symptoms of schizophrenia
21
Q
Typical Antipsychotics can cause…
A
extrapyramidal symptoms
22
Q
Atypical Antipsychotics treats…
A
positive and negative symptoms of schizophrenia
23
Q
What are the side effects of atypical antipsychotics?
A
metabolic syndrome:
- wt gain
- dyslipidemia
- insulin resistance
24
Q
What are the side effects of typical antipsychotics?
A
- akathisia (restlessness)
aka muscle problems
25
What is tardive dyskinesia?
long-term use of antipsychotics can cause involuntary movements of facial muscles, tongue, and limbs
26
All antipsychotics have which side effects?
anticholinergic
27
What do you use to assess extrapyramidal side effects?
AIMS
Abnormal involuntary movement scale
28
What assessment could the nurse perform to assess for extrapyramidal side effects?
feel for cogwheel rigidity in shoulder joints during movement
29
What medications are used to treat EPS symptoms caused by antipsychotic medications?
benadryl
benztropine
30
How do antiretrovirals for HIV work?
-includes at least three medications
-inhibits viral replication or entry into cell
31
Side effects of antiretrovirals for HIV?
flu-like symptoms
skin dryness
rashes
anemia
numbness/tingling
depression
fat redistribution
hepatic/renal failure
32
Immunomodulators?
Interferons
Glatiramer acetate
33
Immunosupressants?
Dimethyl fumarate (Tecfidera)
Mitoxantrone
34
Side effects of psychostimulants?
insomnia, appetite suppression, headache, abdominal pain, lethargy
35
What are Antiretroviral interactions?
PPIs
Antacids
St. John's Wort
36
What are nursing considerations for interferons? (2)
1. report depression or SI
2. photosensitivity
37
What must be avoided when taking immuno-drugs?
rigorous exercise
38
What medications are used for maintenance of anxiety?
SSRI
SSNRI
TCAs
39
What medications are used for acute anxiety?
Benzos
Buspirone
40
How is the acute phase of schizophrenia directed?
Patient safety and medical stabilization
41
How are the stabilization and maintenance phases of schizophrenia directed?
focus on relapse prevention
42
Warning signs of suicide: "Is path warm"
Ideation
Substance Use
Purposelessness
Anxiety
Trapped
Hopelessness
Withdrawal
Anger
Recklessness
Mood Change
43
4 Behavioral warning signs of suicide
1. giving away possessions
2. reckless behavior or risk taking
3. withdrawal from friends and family
4. increased substance use
44
What are the 4 screening tools used for mood disorders?
1. Beck
2. Hamilton
3. Geriatric Depression
4. PHQ-9
45
What is the first line response for bipolar and depression?
medication
46
When is a patient with depression at most risk for suicide?
2-3 weeks after starting medication because they start feeling better
47
How long is the acute phase of MDD?
6-12 weeks
48
What is the first line medication category used for mania?
mood stabilizers
49
What is included in phase 1 of schizophrenia?
florid, disruptive symptoms, marked decrease in daily functioning
50
Treatment of choice for personality disorders?
CBT
DON'T MEDICATE
51
Intervention for BPD
DBT
52
What is the priority of care when working with patients who have personality disorders?
safety
53
What assessment tool is for risk of alcohol dependence?
3 & 10 question AUDITS
54
What score is at risk for alcohol addiction?
8-15
55
What score is at risk for drug addiction?
1-2
56
What is the nursing intervention when the patient is identified as at risk for addiction?
brief intervention
57
What is the nursing intervention when the patient is identified as moderate/high risk for addiction?
brief intervention
referral to treatment
behavioral therapy
58
Alcohol withdrawal symptoms 24-48hr:
anxiety
tachycardia
tremors
irritabiltity
59
Alcohol withdrawal symptoms 48-72hr:
delirium
60
Stimulant (cocaine, amphetamines) withdrawal symptoms:
depression
fatigue
61
Depressant (opiates) withdrawal symptoms:
rhinorrhea
insomnia
cramps
panic
chills/fever
62
What are nursing actions for substance abuse? SBIRT
Screening
Brief-
Intervention
Referral to
Treatment
63
In acute stabilization of substance disorder what is priority?
physical needs
64
What audit score for men is positive?
>4
65
What audit score for women is positive?
>3
66
What is the most difficult time for quitting?
3-6 months after starting
67
What are the nursing actions for the acute phase of grieving?
provide presence
(active listening/observing)
68
When is the average age of onset for mood disorders?
30s and late 60s
69
What is a risk factor for psychosis?
family history
70
What is the average age of onset for anxiety disorders?
11
71
Which ethnicity is most at risk for developing anxiety?
white
72
What gender is most at risk of committing suicide?
men
73
What is the antidote for Anticholinergic Toxicity?
physostigmine
74
Serotonin Syndrome symptoms
GI upset
Mental Status changes
Autonomic hyperactiivty
Neuromuscular dysfunction
75
What are two clear indications of Serotonin Syndrome?
clonus
restlessness
76
Anticholinergic Toxicity symptoms
dry as a bone
blind as a bat
red as a beet
hot as hell
mad as a hatter
77
What is a clear indication of Anticholinergic Toxicity?
constricted pupils
78
What chemical is low with Neuroleptic Malignant Syndrome?
dopamine
79
Neuroleptic Malignant Syndrome symptoms
Fever
Autonomic hyperactivity
Rigidity of muscles
Mental Status changes
80
What are two clear indications of Neuroleptic Malignant Syndrome?
very high fever
abnormal labs
81
What drugs can cause suicide potential from OD effects causing arrhythmias?
TCAs
82
What are 3 considerations with TCAs?
1. take at bedtime
2. anticholinergic
3. orthostatic hypotension
83
What injury is often indicative of abuse?
abdominal injuries
84
What are 2 suicide assessment tools?
SAFE-T
C-SSRS
85
How long does it take for SSRIs to reach full effectiveness?
4-6 weeks
86
What is Euthymia?
time between manic and depressive episodes
87
What do you administer if spasms severe in serotonin syndrome?
cyproheptadine (serotonin blocker)
88
What are the indications for ECT?
major depression
acute psychosis
89
What is the difference between a hypomanic episode and a mixed affective episode?
mixed includes mania and depression
90
How long must the patient feel depressed before being diagnosed with postpartum depression?
4 weeks or longer
91
What are some prodromal symptoms associated with psychosis? (3)
odd behavior
social awkwardness
distractibility
92
positive symptoms of schizophrenia
add to the person
93
negative symptoms of schizophrenia
take away from the person
94
What is included in management of NMS?
initiate cooling measures
administer dantrolene/dantrium (muscle relaxant)
administer bromocriptine/parlodel (dopamine agonist)
administer benzo
95
What labs are abnormal with NMS?
elevated CK, elevated AST & ALT, elevated WBC
96
What may be used as treatment for catatonia?
ECT
97
What is the difference btw schizoid and schizotypal?
schizoid doesn't experience paranoia
98
Histrionic Personality Disorder
Has to be the center of attention
99
Assessment findings congruent with borderline personality disorder:
1. separation anxiety
2. ideas of reference
3. antagonism
4. manipulative
5. splitting defense mechanism
6. impulsive behaviors (suicide and self-harm)
100
Assessment findings congruent with antisocial personality disorder:
1. "normal" by very charismatic
2. manipulative
3. no outward signs of illness
101
FRAMES?
Feedback
Responsibility
Advice
Menu of Alternative Change Options
Empathy
Self-Efficacy
102
Interventions for anorexia nervosa?
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
What medications are often prescribed for anorexia nervosa?
1. multivitamins
2. calcium supplements
3. constipation meds
4. ssri
5. synthroid
104
Lab values of someone with anorexia nervosa?
increased amylase
impaired renal function due to dehydration
low potassium (cardiac dysrhythmias)
105
BMI for anorexia nervosa?
<17
106
Symptoms of Chlamydia
asymptomatic
107
Treatment for chlamydia
antibiotics *doxy
108
When is chlamydia retested after initial treatment?
3 months
109
What is the PLISSIT model used for?
communicating about sexuality
110
PLISSIT
Permission giving
Limited Information
Specific Suggestions
Intensive Therapy
111
What treatments are appropriate for menopause?
hormone replacement therapy
Calcium/vit D
SSRI, catapress, neurotin, SERMS
vaginal moisturizers/lubricants
112
When is a combination of hormones used in HRT?
when the patient still has a uterus
113
Perimenopause length
4 years
114
Perimenopause s/s
menstrual irregularities
hot flashes
vaginal dryness
mood symptoms
115
When are you in menopause?
no menses 12 months
116
average age of onset of menopause?
51.5
117
FSH level indicating menopause?
>30
118
S/S after menopause?
osteoporosis
loss of elasticity
increased risk for cardiovascular disease
119
What education is needed for clients with altered sensory function?
strict blood glucose monitoring
monitoring alcohol consumption
avoid repetititve movements, exposure to chemicals/toxins, smoking
120
Moist exudative macular degeneration interventions?
photodynamic therapy
laser photocoagulation
anti-VEGF therapy
121
Interventions for macular degeneration?
antiangiogenic drugs
wear sunglasses
implantable telescope
lucentis, avastin, eylea, macugen
122
What are the signs/symptoms of HF?
Tachycardia
Orthopnea
Paroxysmal Nocturnal Dyspnea
123
Potassium-sparing diuretic?
spironolactone
124
How do positive inotropes manage HF?
increase myocardial contractility
125
Side effects of ACE inhibitors?
facial angioedema
renal failure
dry NPC
126
Side effects of ARBs?
hypoglycemia
diarrhea
anemia
127
Side effects of beta blockers?
bradycardia
bronchospasm
128
Nursing implications for vasodilators?
Remove nitrates at night...
Used in acute situations...
129
Nursing implications for positive inotropes?
monitor digoxin levels (0.5-2ng/mL)
monitor K and Mg
130
Which laboratory data would indicate the client is experiencing HF?
Elevated BNP
131
Vasodilators?
nitrates
132
Positive inotropes?
dopamine
dobutamine
norepinephrine
milrinone
digoxin
133
ACE inhibitors?
-pril
134
ARBs?
-sartan
135
Signs of digoxin toxicity
vision changes (yellow spots), slow HR, N/V, anorexia
136
s/sx of left sided heart failure
SOB
Cyanosis
Pulmonary edema
137
s/sx of right sided heart failure
JVD
edema
GI congestion
hepatomegaly, splenomegaly
ascites
138
s/sx of pulmonary edema
pink, frothy sputum
139
Risk factors for hyperlipidemia
men older than 45
women older than 35
140
Medications for hyperlipidema?
HMG-CoA (statins)
bile acid sequestrates
niacin
fibrates
Cholesterol absorption inhibitors
PCSK9 Inhibitors
141
Bile acid sequestrates?
1. cholestyramine (Questran)
2. colestipol (Colestid)
3. Colesevelam (Welchol)
142
Fibrates?
Gemfibrozil (Lopid)
Fenofibrate (Tricor)
143
Cholesterol Absorption Inhibitors?
Ezetimibe (Zetia)
144
PCSK9 inhibitors
alirocumab (praluent)
evolovumab (repatha)
145
Hyperlipidemia total cholesterol?
<200 mg/dL
146
Hyperlipidemia triglycerides in females?
>135 mg/dL
147
Hyperlipidemia triglycerides in males?
>160 mg/dL
148
Hyperlipidemia LDL?
>130 mg/dL
149
Hyperlipidemia HDL for men
<45 mg/dL
150
Hyperlipidemia HDL for women?
<55 mg/dL
151
What is average risk ratio for hyperlipidemia?
3-5
152
What diagnostic is indicative of HIV/AIDS?
CD4+ T cell count
153
Visual symptoms of MS?
i. Nystagmus
ii. Diplopia
iii. Blurred vision
154
Speech symptom of MS?
dysarthria
155
Sensation symptoms of MS?
pain
paresthesia
dizziness
Lhermitte's sign
156
What education should the nurse give the patient with multiple sclerosis?
- wear sunscreen (photosensitivity)
- avoid pregnancy
-avoid hot conditions
- avoid infection
157
Humoral immunity?
B lymph
158
Cell-mediated immunity?
T lymph
159
What medications are used to reduce harmful behaviors with those who have autism?
risperidone, olanzapine, quetiapine, and aripiprazole to reduce harmful behaviors
160
What are the s/sx of anticholinergic toxicity?
Salivation
Lacrimation
Urination
Defecation
Gastric cramping
Emesis
Bradycardia
Bronchorrhea
Bronchospasm
