Psych 2

Neuroleptic-induced Parkinsonism and EPS

"Extrapyramidal Side effects= reversible movements disorder induced by neuroleptic medication. This includes dystonic reaction, parkinsonism and akathisia. Nursing intervention: Administer medications as ordered; assess for effectiveness.

List the injectable antipsychotics listed in chapter 2

- Haldol (decanoate haloperidol), - Prolixin (decanoate fluphenazine) Risperidone (Risperdal Consta), - Paliperidone (Invega Sustenna), - Olanzapine pamoate (Zyprexa Relprevv), Aripiprazole (Abilify Maintena

anticholinergic symptoms

- dry mouth= use ice chips or hard candy for relief - blurred vision= assess side effect, which should improve with time - constipation= increase fluid and dietary fiber intake - urinary retention= instruct the cliet to report any frequency or burning with urination, report to physician if no improvement over time - orthostatic hypotension= instruct the client to rise slowly from sitting or lying position

What are therapeutic lithium levels

0.5-1.5 mEq/L (She didnt provide the answer)

photosensitivity

increased reaction of the skin to exposure to sunlight Nursing intervention: caution client to avoid sun exposure; advise client when in the sun to wear protective clothing and sunscreen

tardive dyskinesia

involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors Nursing intervention: assess using told such as AIMS; report occurrence or score increase to physician

After being admitted for a surgical procedure a patient with a history of schizophrenia becomes extremely agitated when other patients are around and believes that others want to cause the patient harm. Which interventions should the nurse use to provide therapeutic milieu for a patient?

place the patient in a private room

A nurse is assigned to care for a client at risk for alcohol withdrawal. The nurse monitors the client, knowing that the early signs of withdrawal will usually develop within how much time after cessation or reduction of alcohol intake?

2- 4 hours

How long does it take an SSRI to work ?

2-4 weeks

dystonic reaction

reaction characterized by muscle spasms, twitching (eye muscle, oculogyric crisis), facial grimacing, or torticollis (neck muscles spasms) Nursing intervention- administer medications as ordered, assess for effectiveness, reassure the client if he or she is frighten

Akathisia

restlessness Nursing intervention: administer medication as ordered; assess for effectiveness

Sedation

state of being calmed Nursing intervention: caution about activities requiring the client to be fully alert, such as driving a car

The patient has been on Prozac (fluoxetine) for 10 years and was recently started abruptly on Celexa (citapolam) what will the nurse be most concerned with the patient exhibiting?

Serotonin Syndrome

what is the life threatening side effect that can occur from the antipsychotic Clozaril?

Agranulocytosis

What is the generic name for Elavil and what type of antidepressant is it?

Amitriptyline -Tricyclic Antidepressant

The nurse is assessing a client on lithium and a loop diuretic. What electrolyte values would the nurse check before administering the client's medication?

Sodium and Potassium

This class of medications are used for acute alcohol withdrawal

Benzodiazepines

what is the class/type of drugs that slows down the central nervous system and ither body systems? (alcohol is an example) a- hallucinogens b- stimulants c- depressants d- club drugs

C- depressants

What is the medication of choice to treat the neuroleptic malignant syndrome

Dantrium/ Dantrolene

What are the clinical manifestations of Serotonin Syndrome?

Diarrhea, cramping, tachycardia, labile blood pressure, diaphoresis, fever, tremor, shivering, restlessness, confusion, disorientation, mania, myoclonus, hyperreflexia, ataxia, seizures, cardiovascular shock, and death.

What is the name of the fastest acting benzodiazepine?

Diazepam (Valium)

What is the antidote for benzodiazepine overdose?

Flumazenil-Romazicon

Which SSRI has the longest halflife thus causing the greatest risk for serotonin syndrome?

Fluoxetine-Prozac

The nurse is assisting a patient diagnosed with anxiety taking Buspar with their menu. Which item would be contraindicated ?

Grapefruit

What two benzodiapeines are used for alcohol detox?

Librium and Ativan

what is the drug of choice for Bipolar disorder

Lithium

Which Mood Stabilizers require a level to be drawn

Lithium, Depakote, Tegretol, Trileptal

What medication is used for detox from Heroin

Methadone

What is the antidote for opioid overdose?

Narcan-Naloxone

What is a life-threatening adverse effect that can occur with antipsychotic medications

Neuroleptic Malignant Syndrome

Is Depakote ( Valproic Acid) safe to take during pregnancy?

No

Is there an antidote for Marijuana overdose

No

Seizures

Nursing intervention: stop medication, notify physician, protect client from injury during seizure; provide reassurance and privacy for the client after the seizure

Neuroleptic Malignant Syndrome (NMS)

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Treatment: dantrolene, D2 agonists (e.g., bromocriptine). Nursing intervention- stop all antipsychotic medications; notify the physician immediately

What is the mechanism of action for SNRI's

SNRI's are potent inhibitors of serotonin and norepinephrine reuptake

What medication is used for withdrawal from Heroin

Suboxone / Subutex

What assessment is important especially in the first 2 weeks a patient is administered an antidepressant?

Suicide assessment

Permanent abnormal movements caused by antipsychotic long term use

Tardive Dyskinesia

What is the term for when a person no longer responds to a drug in the way they did at first, so it takes a higher dose of the drug to achieve the same effects?

Tolerance

A client receiving buspirone with a possible diagnose of hepatitis client sclera looks yellow, What would be the nurse initial action?

Withold the medication

If the patient has an adverse reaction to FGAs also known as Typical antipsychotic can they take Geodon (ziprasidone)

Yes! Geodon is a atypical or 2nd Generation antipsychotic

What is the psychoactive chemical found in marijuana, which give the feeling of being "high"? a- THC b- BBD c- CBD d- ACDC

a- THC

Staff in a mental health unit routinely uses positive and negative reinforcement when caring for a patients with mental health disorders. What needs to be done before the staff can implement these approaches? a- have the patient sign a consent form agreeing to this approach b- Have a health care provider order to use the approaches c- Place a set of 4 point restraints within each patient room d- ensure all patients have medication orders for sedatives

a- have the patient sign a consent form agreeing to this approach

The nurse is preparing to establish a relationship with a newly admitted patient. On which qualities should the nurse focus when creating the nurse-patient relationship? (Select all that apply) a- respect b- empathy c- sympathy d- humor e- honesty

a- respect b- empathy e- honesty

What are the 3 stages of stress in order?

alarm, resistance, exhaustion

Which are accurate examples of time limits for seclusion and restraint protocols for a 12 year old? The RN calls the PHCP for new order every- a- 8 hours b- 2 hours c- 4 hrs d- 6 hrs

b- 2 hours

what is it called when a person keeps using a drug and can't stop, despite negative consequences from using the drug? a- dependence b- addiction c- tolerance d- withdrawal

b- addiction

what is the type/class of drugs that speed up the central nervous system and other body systems? (Caffeine is an example) a- hallucinogens b- stimulants c- depressants d- club drugs

b- stimulants

You are caring for an older patient with a history of depression. Which comment would indicate a need for further assessment? a- " I am old, all my friends have died" b- " I retire in 6 months and it will be all downhill from there" c- " I am useless now, there is no reason to be alive" d- I am looking forward to seeing my husban in heaven someday"

c- " I am useless now, there is no reason to be alive"

A client who has been drinking alcohol on a regular basis admits to having a problem and is asking for assistance with the problem. The nurse would encourage the client to attend which of the following community support groups? a- Families Anonymous b- Fresh Start c- Alcoholic Anonymous d- Al- anon

c- Alcoholic Anonymous

what is the term for when a person needs to take a drug in order to feel or function normal? a- withdrawal b- addiction c- dependence d- tolerance

c- dependence

What is the term for any violence or abuse that is between family members? a- verbal abuse b- neglect c- domestic abuse d- emotional abuse

c- domestic abuse

Which of the following us a pattern that attacks a person's emotional development and sense of self-worth? a- neglect b- domestic abuse c- emotional abuse d- verbal abuse

c- emotional abuse

during a mental assessment a patient cannot remember the name of a childhood neighborhood. In which aspect of the assessment is the patient demonstrating an alteration? a- mood and effect b- speech c- memory d- orientation

c- memory

The nurse observes that a client is psychotic, agitated, and making aggressive gestures. The cline's speech pattern is rapid and the client's affect is belligerent. Based on these observations, the nurse's immediate priority if care is to: a- provide the clients on the unit with sense of comfort and safety b- Offer the client a less stimulating area to calm don and gain control c- provide safety for the client and other clients on the unit d- Assist the staff in caring for the client in a controlled environment

c- provide safety for the client and other clients on the unit

what is the term when a person no longer responds to a drug in the way they did at first, so it takes a higher dose of the drug to achieve the same effect? a- dependence b- addiction c- tolerance d- withdrawal

c- tolerance

What is the term for a group of physical and mental symptoms a person goes through when stopping using a drug? a- dependence b- addiction c- tolerance d- withdrawal

d- withdrawal

A nurse is assigned to care for a client at risk for alcohol withdrawal. The nurse monitors the client, knowing that the early signs of withdrawal will usually develop within how much time after cessation or reduction of alcohol intake? a- in 21 days b- in 14 days c- in 7 days d- within a few hours

d- within a few hours

weight gain

encourage balance diet with controlled portions and regular exercise, focus on minimizing gain