NURS 1023 HESI

Medication for schizophrenia

Haloperidol

Side effects of fluphenazine

Headache, constipation, weight gain, drowsiness, dizziness

Define: Bipolar DO w/ mania

Inflated self-esteem, grandiosity, decreased need for sleep; excessive talking, flight of ideas; easily distracted, engaging in risky activities.

What info about Imipramine should the nurse communicate to the patient? 1. Can cause dry mouth and constipation 2. Stop abruptly if side effects are bothersome 3. Take w/ acidic foods 4. Do not take with cimetidine

1. Can cause dry mouth and constipation 4. Do not take with cimetidine When taken with cimetidine, there is increased absorption and retention of the imipramine, leading to toxicity.

What med is used to treat alcohol dependence?

Disulfiram (Antabuse) Alcohol antagonist

Effects of opioids

1. Pupil constriction 2. Dysphoria 3. Drowsiness, psychomotor retardation 4. Respiratory depression

At a follow-up visit, a client receiving treatment for depression reports blurred vision and constipation. The nurse would suspect which medications as being responsible for these adverse effects? Select all that apply. 1. Phenelzine 2. Amoxapine 3. Maprotiline 4. Desipramine 5. Amitriptyline

2. Amoxapine 4. Desipramine 5. Amitriptyline Amoxapine, desipramine, and amitriptyline are first-generation antidepressants with potential adverse effects of blurred vision and constipation

What medication can be used to treat BPD with mania? 1. Procainamide 2. Valproate 3. Dextroamphetamine 4. Phenytoin

2. Valproate Works in brain to stabilize neurotransmitters during manic phase

Define: antisocial personality disorder

A persistent pattern of disregard for and violation of the rights of others; callousness, or lack of empathy, deceitful, aggressive, manipulative; little to no capacity for intimacy in personal relationships; failure to conform to social norms and laws

What is benzodiepine chlordizepoxide used for?

Alcohol withdrawal

A patient with APD is exhibiting rigid extended neck and a thickening tongue. What med should be administered?

Benztropine (cogentin) These are EP symptoms.

Which medication does the nurse expect the health care provider to prescribe to the patient with seasonal affective disorder?

Bupropion

How do thiazide diuretics affect lithium?

Depletion of Na+ can lead to lithium toxicity

What med is used to reverse effects of benzodiazepines?

Flumazenil

What tricyclic antidepressant is used to treat major depressive DO?

Imipramine (Tofranil)

Treatment for antisocial personality disorder

Lithium

What is naltrexone?

Opioid antagonist that is useful in the case of opioid abuse to reverse the effects produced by opioid drugs.

What is the preferred treatment for PTSD?

Paroxetine (Paxil) Controls depression, hypervigilance, and avoidance of social situations.

Examples of positive symptoms - schizophrenia

1. Agitated behavior 2. Delusions 3. Hallucinations

Symptoms of serotonin syndrome

1. Agitation 2. Delirium 3. Tachycardia 4. Sweating 5. Muscle spasms 6. Tremors 7. Seizures 8. Rhabdomyolysis 9. Dysrhythmias 10. Restlessness, confusion, poor concentration, fever

Alcohol withdrawal symptoms

1. Agitation 2. Increased temp, PR, RR, BP 3. Tremors, lack of appetite, N/V, insomnia, impaired cognition 4. Psychotic symptoms begin 8-10h

Symptoms of alcohol detoxification

1. Agitation, restlessness 2. Diaphoresis 3. Tachycardia 4. Hypertension Autonomic hyperactivity occurs: diaphoresis, HR >100, increased temp, RR, BP

Which action would the nurse take for a client with bipolar disorder, manic episode? 1. Assign private room 2. Suggest playing cards with other clients 3. Encourage development of insight through introspection 4. Have client sit at communal dining table during meals

1. Assign private room During the acute phase of mania, care would be focused on maintaining the safety of the client and others and decreasing the client's energy expenditure.

Symptoms associated with high dose cocaine abuse.

1. Decreased mood 2. Hyptension 3. Psychomotor retardation

Which side effect is associated with venlafaxine? Select all that apply. 1. Diarrhea 2. Dysgeusia 3. Drowsiness 4. Constipation 5. Slurred speech

1. Diarrhea 2. Dysgeusia 3. Drowsiness 4. Constipation

What info about paroxetine should you communicate with the patient?

1. Do not stop abruptly 2. Do not take with aspirin - r/o bleeding

Which herb can produce hypertensive crisis in the patient who is taking monoamine oxidase inhibitors (MAOIs)? Select all that apply. 1. Ginseng 2. Ephedra 3. Feverfew 4. St. John's wort 5. Ginkgo biloba

1. Ginseng 2. Ephedra 4. St. John's wort

Signs of withdrawal in neonate

1. Irritability 2. Tachypnea >60 3. Tremors 4. Excoriations 5. Shrill cry 6. Sneezing 7. Poor feeding 8. Hyperactivity 9. Sleep disturbances 10. Muscle hypertonicity

Which withdrawal signs and symptoms would the nurse assess for in a recently hospitalized client with an opioid use disorder? Select all that apply. One, some, or all responses may be correct. 1. Lacrimation 2. Yawning 3. Drowsiness 4. Constipation 5. Muscle aches

1. Lacrimation 2. Yawning 5. Muscle aches

What info about Valproate should the nurse communicate to the patient? 1. Notify HCP of new or worsening depression 2. Notify HCP for sudden onset of chest pain or swelling in hands and feet 3. Obtain base Hgb A1C w/ follow up every 6 months 4. Eat a diet high in protein and low in carbs

1. Notify HCP of new or worsening depression 2. Notify HCP for sudden onset of chest pain Valproate can, in some individuals, induce or worsen signs of depression and suicidal thoughts

Side effects of antipsychotic meds

1. Pseudoparkinsonism: tremors, rigidity, bradykinesia 2. Anticholinergic: constipation 3. Vision changes 4. Photosensitivity

A client on antidepressant therapy develops hyperthermia, seizures, and a heart rate of 200 beats per minute. Which medication would the nurse suspect is responsible for the condition? 1. Sertraline 2. Asenapine 3. Risperidone 4. Fluphenazine

1. Sertraline A heart rate of 200 beats per minute indicates cardiac dysrhythmias. Hyperthermia, seizures, and cardiac dysrhythmias in a client on antidepressant therapy indicate serotonin syndrome

What info about disulfiram should you communicate with the patient? 1. You may have a metallic or garlic taste in mouth 2. Do not drink alcohol 3. It is safe to continue oral contraceptives 4. Administer antacids at least 2h pre and post admin

1. You may have a metallic or garlic taste in mouth 2. Do not drink alcohol

What info about haloperidol should you communicate with the patient? 1. Take on empty stomach 2. Drink extra fluids 3. Contact HCP w/ irregular heartbeat 4. Avoid taking w/ grapefruit juice

2. Drink extra fluids 3. Contact HCP w/ irregular heartbeat Haloperidol increases r/o dehydration. Irregular heartbeat can be a sign of NMS

The nurse recognizes which medications as leading to a prolongation of the QT interval in a client receiving medication therapy for schizophrenia? Select all that apply 1. Loxapine 2. Haloperidol 3. Thiothixene 4. Thioridazine 5. Chlorpromazine

2. Haloperidol 4. Thioridazine 5. Chlorpromazine First generation antipsychotics

A patient is exhibiting rigid extended neck and a thickening tongue. What statements are true? 1. Continue antipsychotic meds while treating NMS 2. Stop all antipsychotic meds immediately 3. The patient may experience respiratory alkalosis 4. Aggressively treat hyperthermia, if present, w/ cooling blankets & ice packs

2. Stop all antipsychotic meds immediately 4. Aggressively treat hyperthermia, if present, w/ cooling blankets & ice packs The patient may experience metabolic acidosis r/t rigidity of muscles

Which medications would be indicated for management of attention-deficit/hyperactivity disorder (ADHD)? Select all that apply. 1. Modafinil 2. Sumatriptan 3. Atomoxetine 4. Benztropine 5. Methylphenidate 6. Dextroamphetamine

3. Atomoxetine 5. Methylphenidate 6. Dextroamphetamine

Which medication does the nurse administer to the patient with bipolar affective disorder? 1. Fluoxetine 2. Venlafaxine 3. Carbamazepine 4. Imipramine

3. Carbamazepine Bipolar affective disorder is a psychotic disorder in which a patient has mood swings ranging from euphoria to depression. Carbamazepine helps manage the symptoms associated with bipolar affective disorder.

What info about alprazolam (xanax) should you communicate with the patient? 1. Report s/s of constipation 2. Report decreased urination 3. Do not take w/ other meds that make you sleepy 4. Do not take w/ grapefruit juice

3. Do not take w/ other meds that make you sleepy 4. Do not take w/ grapefruit juice

What info about Venlafaxine should the nurse communicate to the patient? 1. Crush tablet if unable to swallow 2. Med safe to take during pregnancy 3. Take med at the same time every day 4. May notice some dizziness and nausea when they start taking med

3. Take med at the same time every day 4. May notice some dizziness and nausea when they start taking med

A client with chronic, undifferentiated schizophrenia is receiving an antipsychotic medication. For which potentially irreversible extrapyramidal side effect would the nurse monitor the client? 1. Torticollis 2. Oculogyric crisis 3. Tardive dyskinesia 4. Pseudoparkinsonism

3. Tardive dyskinesia Occurs as a late and persistent EPS complication of long-term antipsychotics therapy. Manifests in abnormal movements of lips, tongue, and mouth.

A client who smokes heavily is prescribed a high-calorie, high-protein diet. The nurse would encourage the client to eat foods that are high in which vitamin? 1. Niacin 2. Thiamine 3. Vitamin C 4. Vitamin B 12

3. Vitamin C Smoking accelerates oxidation of vitamin C (ascorbic acid) in tissue and blood. As a result, smokers need an additional 35 mg/day.

What is Fluphenazine?

Antipsychotic for treatment of schizophrenia. Given IM every 2-3 weeks

Define: Major depressive DO

At least 5 symptoms during the same 2 week period that include either depressed mood or loss of interest in pleasure; symptoms can include feeling sad, empty or tearful, inability to feel happy, insomnia or hypersomnia, unintentional weight loss or gain, feelings of worthlessness, poor concentration

A client taking escitalopram and St. John's wort should be assessed for what?

Confusion & hyperreflexia Client is at r/o serotonin syndrome by combining escitalopram and St. John's wort

What are the common size effects of benzodiazepine meds?

Drowsiness, dizziness, blurred vision

Symptoms of major depression

Fatigue, difficulty sleeping, loss of interest in work, inability to complete tasks

Which medication would the nurse expect to administer to actively reverse the overdose sedative effects of benzodiazepines?

Flumazenil

What are the signs of neonatal opioid withdrawal?

Frequent sneezing, high-pitched crying, difficulty feeding, hyperactive DTR, diminished Moro reflex.

What increases the risk for suicide?

Impulsivity Panic attacks Unemployment Substance abuse

How does caffeine affect lithium?

Increase lithium excretion

What are the signs of alcohol withdrawal?

Increased temp, diaphoretic, severe headache, increased BP, hallucinations, restlness

Therapeutic effects of lithium

Prevention of extreme mood swings. Reduces anger, aggressiveness, and combative behavior. Mood stabilizer

What medication is used for somatic symptom DO?

Venlafaxine (Effexor XR)

How does haloperidol work?

Works to correct dopamine imbalances in the brain to improve thinking, mood, and behavior

How to admin injection haloperidol

Z-track method Gluteal or deltoid site q4 weeks