MH Pharma ch 14,16,17,18 exam 6/14/17
What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?
"You may feel dizzy or unsteady when rising to a standing position"
In addition to facilitating sleep, what is another benefit of sedatives?
Decreased patient anxiety
Which is true regarding psychological drug dependence?
It requires medical intervention to treat
A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?
Liver function test
A patient who is taking a MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?
Neck stiffness
Bupropion hydrochloride (Wellbutrin) may cause hypertension when is used in combination with which drug?
Nicotine
The nurse is determining the type of anxiety that a patient is experiencing. The t states that he always counts the number of steps that takes to walk to the car. This is an example of:
OCD
A nurse is assessing a patient who has been admitted to the psychiatric unit and who has been hearing voices that told her to lock all the doors and not answer any phone calls. The nurse should administer which scale specific for schizophrenia?
PANSS
On what is the choice of tricyclic antidepressants based?
Patient age and gender
The outcome statement for a patient suffering from anxiety disorder reads, "after 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." which assessment finding validates that this outcome is met?
Patient reports sleeping better and increased interest in activities
Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?
Patient with recent anxiety reactions
For what conditions are benzodiazepines prescribed?
Preoperative sedation
A newly admitted psychiatric patient repetitively states. "I wish i were dead. I just want to kill myself." the priority nursing at this time is to:
Provide for patient safety
Which two phases make up normal sleep?
REM & NREM
What will the nurse caution a patient about when providing information about the prescribed azapirone antidepressant?
Risk for injury when using machinery
The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?
Spend uninterrupted time listening to the patient
The term rebound sleep refers to:
The disturbances of REM sleep that causes restlessness and nightmares
What is the benefit of using zaleplon and zolpidem?
They do not diminish stage 4 or 4 of REM sleep such as benzodiazepines do.
What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?
They do not cause the anticholinergic and cardiovascular adverse effects
To what does potency of an antipsychotic medication refer?
Milligram doses used for the medication
Which statement is true regarding the adverse effects associated with antipsychotic medications?
Painful dystonic reactions can occur in the first 72 hours of initiation of therapy
An older adult patient received a hypnotic agent at 9:00 PM. at 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?
Paradoxical
Which sleep pattern stage diminishes as an effect of aging?
Stage 4
Which drugs may increase the toxic effects of benzodiazepines? SATA
- Analgesics - Alcohol - Antihistamines
Fluoxetine (Prozac) is prescribed for which conditions?
- Depression - Premenstrual dysphoric syndrome
What are the major adverse effects of antipsychotic medications? SATA
- Dysrhythmias - dyslipidemia - Seizures
The nurse is making rounds on the unit during the night shift and notes that one of the older patients is awake. The nurse reviews the patient's bedtime and sees that 5 mg of zolpidem was administered at 2100. For what condition does the nurse evaluate the patient?
- pain - Hangover - Impaired coordination
What does the nurse expect that a patient who is receiving a benzodiazepine who also ingests alcohol may experience?
Addictive effects of the alcohol and the sedative-hypnotic agent
Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?
Assess the patient for thoughts of suicide
A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. What action will the nurse tae?
Assess the patient's blood pressure in sitting and lying positions
The benzodiazepine monograph lists hepatotoxicity as serious adverse effect. Which laboratory test are performed to assess this?
Bilirubin, alkaline phosphatase, gamma glutamyltransferase, prothrombin time
Lithium (Eskalith) is the drug of choice for which of the following disorder?
Bipolar disorders
The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most for the nurse to report to the health care provider immediately?
Bradycardia
Patients who are being treated for depression should continually be monitored for thoughts of suicide. Which behavior may indicate suicidal behavior?
Comments suggesting that "things would be better" after the patient's death
A patient is receiving a benzodiazepine. Which laboratory values does the nurse monitor?
Complete blood cell count with differential and liver function
A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer:
Diphenhydramine
What occurs with mania associated with bipolar disorder?
Distinct episodes of elation
A patient who has been taking an antipsychotic agent developed tongue protrusion, jaw spasms and neck torsions. What are these extrapyramidal symptoms referred to as?
Dystonias
Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?
Dystonic reactions
What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?
Extrapyramidal effects
Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which?
Extrapyramidal symptoms
Which is the drug of choice to treat a patient with OCP?
Fluvoxamine (Luvox)
The nurse assessing a patient who is complaining of hearing voices. What is this patient experiencing?
Hallucinations
Patient has been receiving benzodiazepines for several years. What condition may this cause?
Withdrawal symptoms if the drug is discontinued rapidly
The nurse is developing a teaching plan for patients prescribed buspirone (BuSpar). Which information about this medication should be included?
There is minimal potential for abuse
What information does the nurse include during patient teaching for antianxiety therapy?
"Notify your physician if hangover symptoms persist, because the dose may need to be reduced or the medication changed".
A patient is taking an MAOI is monitored for which?
Hypertension
The nurse is teaching a patient who is taking clozapine (Clozaril), an antipsychotic drug, to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?
Agranulocytosis
A severe reactions can occur between SSRIs and which drugs?
Birth control pills
What is the action of MAOIs on neurotransmitters?
Blocking their destruction