Mental Health Ch 3 - Psychobiology and Psychopharmacology
A 49-year-old patient diagnosed with schizophrenia at 22 years old is prescribed risperidone. Which nursing assessment is the priority for this patient? A. Monitoring blood levels to avoid toxicity B. Monitoring for abnormal involuntary movements C. Observing for secondary mania D. Observing for memory changes
B. Monitoring for abnormal involuntary movements Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-generation antipsychotic medications, thus making it imperative to monitor for EPSs. Risperidone is not monitored with blood levels and does not cause mania or memory changes.
The nurse caring for a client prescribed an antidepressant medication that produces anticholinergic side effects should assess for which possible side effects? Select all that apply. Memory dysfunction Ejaculatory dysfunction Blurred vision Dry mouth Constipation
Blurred vision Anticholinergic effects are the effects produced by atropine: dry mouth, dry eyes, blurred vision, constipation, and urinary retention. None of the remaining options are associated with anticholinergic side effects. Dry mouth Anticholinergic effects are the effects produced by atropine: dry mouth, dry eyes, blurred vision, constipation, and urinary retention. None of the remaining options are associated with anticholinergic side effects. Constipation Anticholinergic effects are the effects produced by atropine: dry mouth, dry eyes, blurred vision, constipation, and urinary retention. None of the remaining options are associated with anticholinergic side effects.
distrurbances of mental function
first q you should ask is drugs theyre taking 6
know and understand what neurotransmitters do
they send signals messengers chemical substance that functions as messenger
A 38-year-old patient diagnosed with major depression states, "my provider said something about the medicine I've been prescribed will affect my neurotransmitters. What exactly are neurotransmitters?" What is the nurse's best response to the patient's question? A. "Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression." B. "Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood and make you less depressed." C. "Neurotransmitters are chemicals in the brain that are the reason you are depressed." D. "I will ask your provider to give you a more in-depth explanation about why this medication will help your depression."
A. "Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression." Neurotransmitters are chemicals released from neurons that function as a neuromessenger and influence brain functions. Telling the patient that the answer is too complicated belittles the patient by implying she cannot understand, while stating that neurotransmitters are the reason she is depressed is too simplistic. Asking the provider to give the education abdicates your responsibility to provide patient education.
Based on the current understanding of brain physiology, which neurotransmitter would be the expected target of medication prescribed to manage depression? Select all that apply. A. Dopamine B. γ-aminobutyric acid (GABA) C. Serotonin D. Norepinephrine E. Acetylcholine
A. Dopamine C. Serotonin D. Norepinephrine Antidepressant medication targets serotonin and norepinephrine. While dopamine is implicated in schizophrenia (increase) and Parkinson's disease (decrease), it is also believed to be a factor in depression. GABA is implicated in anxiety disorders. Acetylcholine is implicated in Alzheimer's disease as well as Huntington's disease and Parkinson's disease.
When treating mental illnesses with psychotropic drugs what is the focus of the treatment? Altering brain neurochemistry. Correcting brain anatomical defects. Regulating social behaviors. Activating the body's normal response to stress.
Altering brain neurochemistry. Psychotropic drugs act to increase or decrease neurotransmitter substances within the brain, thus altering brain neurochemistry.
Which assessment should the nurse perform to evaluate the pharmacokinetic affect of a monoamine oxidase inhibitors (MAOIs) antidepressant medication? A. The status of the client's appetite B. The results of the liver function test C. The level of depression exhibited by the client D. The client's current sleeping patterns
B. The results of the liver function test Pharmacokinetics refers to the movement of a drug through the body. Four basic processes of pharmacokinetics which determine the concentration of a drug at its sites of action are easily remembered with the acronym ADME: absorption, distribution, metabolism, and excretion. MAOIs can affect liver function and require monitoring. The other options are related to the medication's pharmacodynamic effects.
What term is used to identify the structures that respond to stimuli, conduct electrical impulses, and release neurotransmitters? Neurons Synapses Dendrites Receptors
Neurons Neurons are the basic functional unit of the nervous system responsible for sending and receiving messages as electrochemical events.
A prescription for which medication would require the nurse to monitor the client for potential development of the side effect of hypothyroidism? A. Fluoxetine B. Bupropion C. Lithium D. Imipramine
C. Lithium Long-term use of lithium may cause hypothyroidism. The other options refer to drugs whose long-term use does not cause hypothyroidism.
What is the function of a neuron? Conduction of electrical impulses Diffuses an impulse across a space Provides a space at an axon terminal Provides an attachment point of the cell surface
Conduction of electrical impulses Neurons are nerve cells that conduct electrical impulses. A neurotransmitter is a chemical substance that functions as a neuromessenger. This neurotransmitter then diffuses across a space, or synapse, to an adjacent postsynaptic neuron, where it attaches to receptors on the neuron's surface
The nurse caring for a client prescribed risperidone observes the client carefully for which possible side effects? Select all that apply. Daytime sleepiness Reports of heartburn A rapid heartbeat Sexual dysfunction A weight gain
Daytime sleepiness Risperidone is a D2 antagonist that has the potential to produce sedation, weight gain, and sexual dysfunction. None of the other side effects are generally associated with this medication. Sexual dysfunction Risperidone is a D2 antagonist that has the potential to produce sedation, weight gain, and sexual dysfunction. None of the other side effects are generally associated with this medication. A weight gain Risperidone is a D2 antagonist that has the potential to produce sedation, weight gain, and sexual dysfunction. None of the other side effects are generally associated with this medication.
Which organ secretes hormones that are a normal component of the body's general response to stress?Select all that apply. Thyroid gland Hypothalamus Pituitary gland Adrenal glands Parathyroid glands
Hypothalamus The hypothalamus, pituitary, and adrenal glands act as a system that responds to mental and physical stress. The organs secrete corticotropin-releasing hormone, corticotropin, and cortisol; all influence the function of nerve cells of the brain. None of the remaining options secrete hormones associated with general stress. Pituitary gland The hypothalamus, pituitary, and adrenal glands act as a system that responds to mental and physical stress. The organs secrete corticotropin-releasing hormone, corticotropin, and cortisol; all influence the function of nerve cells of the brain. None of the remaining options secrete hormones associated with general stress. Adrenal glands The hypothalamus, pituitary, and adrenal glands act as a system that responds to mental and physical stress. The organs secrete corticotropin-releasing hormone, corticotropin, and cortisol; all influence the function of nerve cells of the brain. None of the remaining options secrete hormones associated with general stress.
When a tumor of the cerebellum is present, the nurse should expect that the client would initially demonstrate which sign/symptom? Impaired balance Abnormal eye movement Impaired social judgment Blood pressure irregularities
Impaired balance The cerebellum is the organ primarily responsible for symptoms of equilibrium or imbalance and would not be a likely source of any of the other options.
The medication prescribed for a client acts by blocking reuptake of both serotonin and norepinephrine. The nurse evaluates the treatment as successful when observing which client behavior? Laughing at a joke Apologizing for being sarcastic Writing down his telephone number Going to his room to "calm down"
Laughing at a joke Depression is thought to be at least in part caused by lowered levels of serotonin and norepinephrine. Increasing the amount of these transmitters in the brain by blocking reuptake may result in mood elevation. While the other options demonstrate positive behaviors, none are directly associated with such a medication.
The nurse responsible for the care of a client prescribed clonazepam should evaluate treatment as being successful when the client demonstrates which behavior? Less anxiety Normal appetite Improved physical balance Reduced auditory hallucinations
Less anxiety Clonazepam is a benzodiazepine thought to enhance the effects of GABA. GABA is associated with the production of a calming emotional state. None of the other options are associated with clonazepam.
Which imaging technique can provide information about brain function? Computed tomography (CT) scan Positron emission tomography (PET) scan Magnetic resonance imaging (MRI) scan Skull radiograph
Positron emission tomography (PET) scan The positron emission tomography scan provides information about function; the other imaging techniques provide information about structure.
The incoherent thought and speech patterns of the client diagnosed with schizophrenia are related to the brain's inability to perform which function? Regulate conscious mental activity. Retain and recall past experience. Regulate social behavior. Maintain homeostasis.
Regulate conscious mental activity. When the brain cannot regulate conscious mental activity, the individual's speech patterns demonstrate incoherence and lack of reality orientation.
Homeostasis is promoted by interaction between the brain and internal organs and is mediated by component of the nervous system? The central nervous system The autonomic nervous system The sympathetic nervous system The parasympathetic nervous system
The autonomic nervous system The function of the autonomic nervous system is to transmit messages between the brain and the internal organs. This linkage promotes the maintenance of homeostasis.
Anxiety and Hypnotic Drugs (cont.) she will ask about sleeping pill: "Z-hypnotics"
Short-acting sedative hypnotic sleep agents ("Z-hypnotics") ◦Zolpidem (Ambien) ◦Zaleplon (Sonata) ◦Eszopiclone (Lunesta)
Which function is classified as a circadian rhythm? Sex drive Sleep cycle Skeletal muscle contraction Maintenance of a focused stream of consciousness
Sleep cycle Circadian rhythms are biological rhythms that influence specific regulatory functions such as body temperature, sleeping and waking, and the secretion of certain hormones and neurotransmitters.
