Mood Disorders & Anemia Flashcards
(17 cards)
Behavioral Therapy techniques
Operant Conditioning: rewards good behaviors (includes +- reinforcement).
Aversion Therapy: punish bad behaviors.
Systematic desensitization for phobias.
CBT addresses…
Cognitive distortions.
SNRIs
Duloxetine, Venlafaxine.
More GI symptoms than SSRIs
TCAs
Amitriptyline. Imipramine. Doxepin.
Anticholinergic effects, weight gain.
Not for suicidal pts because overdose is more likely to be lethal.
MAOIs
Phenelzine. Selegiline. Isocarboxazid.
Many negative drug interactions.
Can cause HTX crisis by stopping break down of tyramine.
Avoid: aged meats/fish, aged 🧀, beer/wine, yeast, protein supplements, some fruits/vegetables.
Atypical antidepressants
Bupropion/Wellbutrin:
AE- suppresses appetite.
Used to counter sexual side effect & smoking cravings.
NOT for seizure disorders or anorexia.
Trazodone: used as sedative
Nursing considerations for antidepressants
6-8wks
Sexual dysfunction (except bupropion)!
Black box: increases suicide in short-term d/t increased energy.
Must be tapered (except fluoxetine) to avoid discontinuation syndrome.
Serotonin syndrome
Usually caused by 2 dif meds (especially MAOI w/another antidepressant).
HARMFUD: hyperthermia, autonomic instability, rigidity, myoclonus, fever, unconsciousness, diarrhea
Hold meds, cyproheptadine if symptoms persist.
2nd gen antipsychotics
Clozapine, olanzapine, risperidone
Positive & negative symptoms
Lower risk of EPS
What to do if someone shows EPS?
Hold meds
Call provider
Give benztropine
1st gen antipsychotics
Haloperidol
Chlorpromazine
What are the two psychotic med emergencies?
NMS (FEVER) - prepare for transfer to CCunit, cool body. High fever, muscle rigidity)
Agranulocytosis (esp clozapine, always assess for infection)
Anticonvulsants
Valproate. Carbamazepine. Lamotrigine
SJS (flu-like, painful rash), high risk for lamotrigine, titrated very slowely.
Others- monitor liver enzymes
Lithium
V narrow therapeutic index (1.5 is toxicity - severe/coarse hand tremors, severe diarrhea, vomiting, confusion, wkness). Minor GI is normal. Hold med and notify.
Lithium is a salt(normal fluid and sodium intake).
Sicle cell crisis causes & long-term prevention
Reduced blood flow (MI/Ischemic).
Dehydration, cold weather, high elevation, infection.
Prevent dehydration and infection and the cold. Take folic acid & hydroxyurea.
Interventions for sickle cell crisis
Manage Pain!
O2, fluids, pain meds, abx if infection.
Warm compresses to joints.
Maybe blood transfusions.
S/s of iron-deficiency anemia
Menorrhagia & GI bleeding (ulcers, alcohol abuse, aspirin/steroids/NSAIDS).
Multiple pregnancies, nutritional deficiencies.
Low Hgb/Hct, low iron
Wkn, fatigue, pallor, dizzy, HA, pica, resp, palpitations/tachy, restless leg syndrome,
chest pain, brittle/riged nails, poor focus, smooth/red tongue
