Mental Health Drugs

A nurse is caring for a client who has a paranoid schizophrenia and is taking QUETIAPINE. The nurse should monitor the client for which of the following adverse reactions?

-Cataracts (Clients should have baseline and ongoing eye exams) -Sedation -OrTH HoTN -Anticholinergic effects -Prolonged QT interval -Moderate risk of diabetes, weight gain, and dyslipidemia

The nurse is caring for a client who is taking chlorpromazine. Which of the following sympoms should the nurse identify as the client experiencing EPS?

-Dystonia (spasm of tongue, neck, eyes, face, back) -Tardive dyskinesia (involuntary [m] of face, tongue, lips, and limbs) -Akathisia (inability to sit still) -Pseudoparkinsonism (drooling, shuffling gait, tremors)

The nurse is collecing data from a client who is taking alprazolam. Which of the following adverse effect should the nurse closely monitor for?

-Excessive use and abuse -blood dyscrasias -hepatotoxicity

The nurse is reinforcing teaching with a client who has depression about the medication fluoxetine (Prozac). Which of the following statements indicates understanding of the teacing

-FLuoxetine has a long elimination 1/2 life (risk of interactions persists several days / weeks after SSRI withdrawal) -Fluoxetine may diminish the metabolism of phenytoin and cause phenytoin toxicity -Fluoxetine is used for tx of OCD, by reducing symptoms (cannot prevent OCD)

The nurse is caring for a client who has a prescription of alprazolam 0.25 mg PO every 8 hr PRN for anxiety. For which of the following situation should the nurse give the medication?

-HR is very fast Alprazolam (Xanax) is tx for anxiety associated with alcohol withdrawal

A nurse is reinforcing discharge teaching for a client who has biploar disorder and is beginning to take lithium. Which of the following instructions should the nurse include in the teaching?

-Maintain consistent level of salt in diet (AVOID DIETING) -Older adults may develop LITHIUM INDUCED GOITER AND HYPOTHYROIDISM -Do not drink alcohol while taking lithium -Do not take OTC, unless prescribed by MD -Females on contraceptive → need a more reliable form -Drink 2-3L of fluids per day -Lithium levels must be checked regularly

A nurse is reinforcing teaching with a client about manifestations of lithium toxicity, which of the manifestations should the nurse include in the teaching?

-Persistent vomitng -Profuse diarrhea -fine hand tremors

A nurse is reinforcing teaching wih a client who has a new prescription of amitriptyline. What should the nurse include in the teaching regarding adverse reactions of amitriptyline?

-numbness -tingling -dysrhythmias -tachycardia -Heart Failure REPORT THESE TO MD

The nurse is caring for a client who is taking MAOI for treatment of OCD. The nurse should monitor the client for which of the following signs of hypertensive crisis due to tyramine consumption (SELECT ALL)?

-occipital headache -stiff neck -sweating -N -V -Sharp elevated BP

Which patients will be prescribed TCA?

-posttherapeutic neuralgia (pain after shingles) -phantom limb pain -cancer pain -peripheral neruopathy -antidepressant -mild tranqulizing effect -chronic pain -eating disorder

The nurse is collecting data from a client who is to begin taking alprazolam. which of the following should the nurse identify as a contraindication for taking this medication?

-smoking and Rifampin → enhances metabolism so you need larger dose of alprazolam to maintain effect -Glaucoma -Avoid CNS depressants like antihistamines or alcohol **Report increased anxiety to MD ASAP!

A nurse is collecting data from a client who is taking buproprion, which of the follow indicates that the medication is effective?

1. Depression improves 2. Urge of smoking is decreased

A nurse is caring for a client who schizophrenia and is taking haloperidol. The nurse should monitor the client for which of the following adverse reactions?

1. Extrapyridmal Side Effects (EPS) -Dystonia (spasm of tongue, neck, eyes, face, back) -Tardive dyskinesia (involuntary [m] of face, tongue, lips, and limbs) -Akathisia (inability to sit still) -Pseudoparkinsonism (drooling, shuffling gait, tremors) 2. Neuroleptic Malignant Syndrome (NMS) -high fever -dysrhythmias -muscle rigidity 3. Agranulocytosis 4. Anticholinergic Effects

A nurse is preparing to administer olazapine 7.5 mg with avail dosage being 2.5 mg. how many tablets do you give?

3 tablets

The patient has been admitted for further treatment of psychotic disorder. After 5 days, the patient reports fatigue, dizziness, dry mouth, and constipation. The nurse explains that these side effects are due to which factor r/t the medication

Adverse Anticholinergic effect of antipsychotic drugs

The nurse is caring for a client who is taking clozapine for the treatment of schizophrenia. The nurse should monitor the client for which of the following potential side effects?

Agranulocytosis → potentially life-threatening SE: -fever, malaise, leukopenia, ulcerative sore throat -common side effect is TACHYCARDIA

Which of the following physician order would the nurse question if the patient is allergic to phenothiazine?

Anything ending in: -zine

A nurse is reinforcing dietary teaching with a client who has a new prescription for MAOIs. What should you avoid?

Avoid foods that are high in tyramine: -fermented -cured -aged -spoiled AVOID FOR 3 MORE WEEKS AFTER STOPPING MAOI

A nurse is reviewing pamphlets about sertraline with a client who has PTSD. Which of the following statements by the client indicates understanding of the medication regarding adverse side effects of sertraline?

Common: -Sexual dysfn in men & women -N+V -restlessness -agitation -insomnia -sedative effects Serious: -suicidal actions Seritonin Syndrome: -irritability -increased muscle one -shivering -myoclonus (spasmodic jerkey contractions of groups of muscles) -reduced consciousness

A nurse is reinforcing teaching about valproic acid with a client who has a bipolar disorder. Which information should a nurse include in the teaching?

Complicaitions: 1. GI effect → take with food 2. Hepatotoxicty → CONTRAINDICATED WITH LIVER DISORDERS, monitor liver function regularly, do not give to children under 2, administer lowest effective dose 3. Thrombocytopenia 4. Weight gain → low caloria diet and engage in regular exercise (MONITOR YOUR WEIGHT)

The nurse is reviewing a medical record for a client who has a new prescription for CLOZAPINE, which of the following findings should the nurse identify as a CONTRAINDICATION for the medication?

Contraindicated for clients who have dementia; all atypical antipsychotics can cause death r/t stroke / infection

A nurse is reinforcing teaching with a family of a client who is prescribed Miltown. Which of the following manifestations should the nurse monitor to determine that the drug is working well?

Decrease in level of anxiety to a manageable place → coping improves / physical signs such as appearance, tremors, and pacing are lessened

The nurse is caring for a client who has schizophrenia and is receiving clozapine. Which of the following findings should the nurse monitor to determine whether the medication is having a therapeutic effect or not?

Decreased hallucinations is the therapeutic effect!

A nurse is reinforcing teaching with a client who is to begin taking MAOI in addition to SSRI, which of the following information should the nurse include in the teaching?

If taking normal SSRI: 2 week interval before starting MAOIs If taking Fluoxetine SSRI: 5 week interval before starting MAOI

A nurse is caring for an older adult client who has a prescription for lorazepam 0.5 mg, which of the following findings should the nurse report to the provider immediately?

Increased anxiety

A patient who is taking SSRI develops DVT and requires treatment with warfarin. What drug-drug inteactions will occur r/t SSRI + warfarin?

Increased risk of bleeding

The nurse is assisting with the admission of a client who has bipolar disorder and is experiencing an acute depressive episode. Which of the following prescription should the nurse anticipate the pt will receive from the provider?

Lithium (to stabilize the depression)

A nurse is reinforcing teaching with a female client who is prescribed chlorpromazine. Which of the following statements by the client indicates an understanding of the treatment

Medication can pass through breast milk and may harm a nursing baby → never breast-feed while taking the medication

A patient has been depressed and suicidal reports taking TCA for 2 weeks is ready to leave the hospital and go home. Which of the following is a concern for the nurse when finalizing discharge plans?

Monitor pt for SUICIDAL PLANS → SAFETY bc TCA causes suicidal ideation

The nurse is reinforcing teaching with a client about a new prescription for lithium. When is the lithium level checked?

Monitored once or twice weekly during the initiation of therapy -monthly when the pt is receiving maintenance dosage -blood should be drawn approx. 12 hours after the last dose was administered

The nurse is collecting data from a client who is receiving multiple antipsychotic medications. The client exhibits muscle rigdity, hyperprexia, and diaphoresis. The nurse should identify that the client may be exhibiting which of the following adverse reactions?

Neuroleptic Malignant Syndrome (NMS) Ex: high grade fever, dysrhythmias, muscle rigitiy, hyperprexia, diaphoresis

A nurse is caring for a client who has depression and is taking MAOI, the nurse should inform the client that his diet may include which of the following?

No foods that contain tyramine → Cottage and cream cheese (not aged!)

The nurse is caring for a client who is exhibiting signs of seratonin syndrome. Which of the following is the nurse's priority intervention?

Preparing for artificial ventilation

A nurse is reviewing a lab result for lithium carbonate (1.8 mEq/L). What should the nurse do?

Report to the MD immediately (0.4-1.2 mEq is normal range for lithium)

A nurse is reinforcing teaching with a client who is about to take Lithium carbonate. Which of the following dietary supplements should the nurse instruct the patient to avoid?

St. John's Wart

A nurse in a mental facility is discussing antidepressant medication with a newly licensed nurse comparing SSRI and TCA. Which of the folloing information should the nurse include about TCA?

TCA takes about 3 weeks SSRI is 2-4 weeks

A nurse is reinforcing teaching with clients taking lithium for bipolar disorder. Which of the following instructions should the nurse tell the client about the medication?

Take lithium with food

A nurse is reinforcing teaching with a client who has major depressive disorder about a new prescription for vilazodone. Which of the following statements by the client indicates understading of teaching?

Take vilazodone with food for optimal absorption

A nurse is caring for a client who reports nausea and vomiting when taking venlafaxine. What should the nurse tell the patient to do?

Take with food or milk to prevent N&V at the same time everyday

A nurse is collecting data who has schizophrenia and is taking fluphenazine. The observes that the client's tongue is protruding and there is an irregular movement of the lips. What is going on with the patient?

Tardive dyskinesia Ex: involuntary [m] of face, tongue, lips, and limbs

A nurse is caring for a client who is taking nefrazodone for depression. Which of the following findings is the nurse's priority

The heart (Bradycardia)!! Major disadvantage for life threatening liver fn: need to check AST, ALT, GTT Serious SE: Hepatotoxicity, Bradycardia

The nurse is reinforcing teaching with a client who has thioridazine. What is the use of the drug?

Used for tx of schizophrenia and psychosis; it may, however, lengthen the QT interval, thus leading to dysrhythmias or cardiac arrest *Can cause fatal heartbeat irregularities

Difference between Wellbutrin SR and XL

Wellbutrin SR: Slow-release → given BID Wellbutrin XL: Extended-release → given ONCE a day

A nurse is caring for a client who has bipolar and is taking lithium. The client reports blurred vision and nausea. What should the nurse do?

Withold the medication

Name the test that should confirm whether the patient has a mental illness or not (fill in the blank)

none

A nurse is reinforcing teaching for a client who will begin taking paroxetine. Which of the following statements indicates the client understands the teaching?

paroxetine is a SSRI used as tx for anxiety (has the shortest 1/2 life of all SSRI, but most INTENSE withdrawal symptoms) Drug/Drug interactions: -Phenytoin → enhances metabolic rate (increase paroxetine) -Cimetidine → inhibits metabolism of paroxetine -Coumadin → increases anticoagulant effect = BLEEDING ****Pt may experience initial loss of appetite, but it will go away overtime

A nurse is caring for a client who has schizophrenia and is taking haloperidol. The nurse observes that the client developed a stuporous posture and shuffling gait. The nurse should document the findings as which of the following EPS adverse effects of haloperidol?

pseudoparkinsonism (shuffling gait, stuporous posture, etc.)

A nurse is reinforcing teaching with a client who has several new prescription for psychotrophic medication. The client tells the nurse that she always has trouble following a medication regiment. Which of the following responses should the nurse say?

something thereputic af