Mental Health Exam 2
A 56-year-old man is admitted to the inpatient unit after family members report that he seems to be experiencing auditory hallucinations. The man has a history of schizophrenia and has had several previous admissions. Which statement indicates to the nurse that the client is experiencing auditory hallucinations?
"I am not the devil! Stop calling me those names!" The client is responding to messages that he is hearing, which are auditory hallucinations.
A young client with schizophrenia says, "I'm starting to hear voices." What is the nurse's most therapeutic response?
"I understand that you're hearing voices talking to you and that the voices are very real to you. What are the voices saying to you? Acknowledging that client is hearing voices talking to him and that the voices are very real to him validates the presence of the client's hallucinations without agreeing with them, which communicates acceptance and can form a foundation for trust; it may help the client return to reality.
Describe Paranoid schizophrenia
Paranoid: Delusions (especially persecution) and hallucinations
A client with schizophrenia is demonstrating waxy flexibility. Which intervention is the best way to manage the possible outcome of this behavior?
Passive range-of-motion exercises three times a day for effective joint health Waxy flexibility is an excessive and extended maintenance of posture that can lead to a variety of problems, including joint trauma.
When does bipolar disorder usually emerge?
Late adolescence/early adulthood.
A client with schizophrenia says to the nurse, "I've been here 5 days. There are five players on a basketball team. I like to play the piano." How should the nurse document this cognitive disorder?
Loose association These ideas are not well connected and there is no clear train of thought. This is an example of loose association.
Cocaine is a __________________?
Stimulant
Cocaine exerts which of the following effects on a client?
Stimulation and anesthetic effects
What are clang associations?
Stringing together words that sounds alike or rhyming without regard to their meaning.
What are the Positive Symptoms?
1. Delusions 2. Hallucinations 3. Disorganized Speech 4. Disorganized or Catatonic Behavior
Name 2 street names for rohypnol.
1. date rape 2. roach
What is the severe SE associated with Clozapine?
Agranulocytosis
Define stage of change Comtemplation
Defining Characteristic: Ambivalence about change.
What are the side effects of taking Lithium?
GI distress, fine hand tremor, Inability to concentrate urine.
Define undoing
Performing an act to make up for prior behavior.
Therapeutic Level of Lithium?
0.8 to 1.4 mEq/L
How is addiction characterized (3 things)
1) loss of control of substance consumption 2) substance use despite associated problems 3)tendency to relapse
Describe Undifferentiated schizophrenia
Undifferentiated: Mixture of Catatonic, Disorganized, and/or Paranoid
Tell me about Acamprosate ( Campral)
Used by people who have quit drinking and wish to remain abstinent
Tell me about Disulfiram ( Antabuse)
Used for highly motivated patients who have shown the ability to stay sober -must be taken daily -produces undesirable reaction when patient drinks alcohol -tachycardia, facial flushing, sweating, headache, neck pain and nausea/vomiting
What are the common side effects of antipsychotics?
Weight gain, Sedation, Diabetes, metabolic syndrome
The term tolerance, as it relates to substance abuse, refers to
the need to take larger amounts of a substance to achieve the same effects.
Nursing assessment of an alcohol-dependent client 6 to 12 hours after the last drink would most likely reveal the presence of
tremors.
A syndrome that occurs after stopping use of a drug is
withdrawal.
Tell me about Naltrexone (Revia, Trexan)
works by blocking opiate receptors and helps to reduce craving for alcohol -don't get same euphoric feelings due to receptors being blocked-
How fast is alcohol metabolized?
25mg/L/Hr
The first-line drug used to treat mania is A. lithium. B. carbamazepine. C. lamotrigine D. clonazepam.
A. lithium.
What is the difference between major depression and bipolar disorder?
Bipolar disorders: experience both emotional poles (1) depression and (2) mania: abnormally elevated or expansive mood that includes an inflated sense of self, requires less sleep, experience racing thoughts, feel a constant need to talk, some delusions and hallucinations
An unconscious client is admitted to the emergency department. The admitting diagnosis is "rule out opiate overdose." Which item of assessment data would be most consistent with opiate overdose?
Blood pressure, 80/40 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min
CAGE Test (what do the letters stand for)
C - Cut Down A - Angry, annoyed G - Guilty E - Eye Opener
Which client statement demonstrates positive progress toward recovery from substance abuse?
"Taking those pills got out of control. It cost me my job, marriage, and children."
How would you treat NMS?(Name 3)
1. Supportive measures to lower temp and ensure good fluid intake are essential (cooling blankets, cold H2o bath) 2. Correct electrolyte abnormality 3. Monitor for signs of impending respiratory failure secondary to severe muscle rigidity and inability to handle oral secretions
What are the Negative Symptoms?
1. Affective Flattening- a decrease in level of emotion. 2. Alogia- inability to speak due to mental disability, mental confusion, or aphasia 3. Avolition- lack of motivation
What 2 herbal drugs can cause serotonin syndrome?
1. St. John's wort and 2. ginsing
3 Akathesia Symptoms
1. restlessness, 2. jumping out of skin, 3. uncomfortable, may be miss diagnosed as anxiety symptoms
4 Medication Nursing interventions for EPS
1. Diphenhydramine hydrochloride (Benadryl), 2. Bromocriptine Mesylate (Parlodel), 3. Benztropine mesylate (Congentin), 4. Trihexyphenidyl (Artane)
What 2 pharmacological interventions can you employ with NMS?
1. Dopamine agonists (bromocriptine and amantadine) and/or direct muscle relaxants (dantrolene) (Dopamine agonists in high doses can cause psychosis and/or vomiting) 2. Benzo's to relax if agitated or catatonic
What is echolalia/ echopraxia?
1. Echolalia- is the repetition of what you are told 2. Echopraxia- is the repetition of movements
What are 9 symptoms of NMS?
1. Hyperpyrexia 2. Incontinence 3. Severe EPS 4. Stupor 5. Delerium 6. Coma 7. Tachycardia 8. Hypertension 9. Seizure
What 4 illicit drugs can cause serotonin syndrome?
1. LSD 2. ecstacy 3. cocaine 4. amphetamines
Dystonia Symptoms (Name 5)
1. Oculogyric crisis (rotating eyeballs), 2. torticollis (twisted neck), 3. retrocollis, 4. facial grimacing and 5. laryngeal spasms
6 Neuroleptic Malignant Syndrome Symptoms
1. Severe muscle rigidity, 2. elevated temperature. 3. Change in level of consciousness, 4. leukocytosis, 5. elevated creatinine phosphokinaase, 6. elevated liver enzymes or myoglobinuria
By identifying behaviors commonly exhibited by the client who has a diagnosis of schizophrenia, the nurse can anticipate:(Name 3)
1. Withdrawal, 2. regressed behavior, and 3. lack of social skills
3 important things about disulfiram (Antabuse)
1. causes adverse reactions when person drinks 2. last dose will last up to 2 weeks 3. must know about and stay away from "hidden" alcohol in food, medicines, and preparations that are applied to the skin
Antipsychotic First generation side effects
1. extrapyramidal symptoms, 2. tardive dyskinesia, 3. sedation 4. weight gain, 5. orthostatic hypotension 6. tachycardia, 7. dry mouth, 8. constipation, 9. blurred vision, 10. hyperprolactinemia
3 Electrolyte disturbances that may occur secondarily in NMS
1. hypocalcemia, 2. hypomagnesemia, and 3. hypophosphatemia
4 Symptoms that would signal opioid withdrawal include
1. lacrimation, 2. rhinorrhea, 3. dilated pupils, and 4. muscle aches.
Name 6 side effects of ketamine?
1. panic 2. rage 3. paranoia 4. impared motor 5. vision vomiting 6. respitory problems
5 important things about naltrexone (ReVia)
1. sed for narcotic addition and alcoholism 2. blocks opiate receptors reducing or eliminating the craving 3. low toxicity, with very few side effects 4. Not addictive 5. Only need to take every 3 days
2 important factors about acamprosate (Campral)
1. treat alcoholism; maintain abstinence long term 2. works to reduce the intake of alcohol by suppressing excitatory neurotransmission and enhancing inhibitory transmission (suppresses the food feeling you get by using the substances)
Name 6 side effects of ghb?
1. vomiting 2 weakness l 3. oss of perephial vision 4. hallucionatinons 5. agitaion 6. lightheadidness
What are symptoms of opioid withdrawal?
Agitation, insomnia, flulike manifestations, rhinorrhea, yawning, sweating, diarrhea. Suicidal ideation may occur.
A nurse is caring for a client with the diagnosis of schizophrenia. What is a common problem for clients with this diagnosis?
Disordered thinking
What is neuroleptic malignant syndrome (NMS)?
An acute, potentially fatal, idiosyncratic reaction to a neuroleptic medication (which for most part are the anti-psychotic medications)
A newly admitted male client with schizophrenia appears to be responding to internal stimuli when laughing and talking to himself. What is the best initial response by the nurse?
Asking the client whether he is hearing voices Because the client is newly admitted, the nurse needs to conduct a thorough assessment before intervening.
Which of the drugs used by a polysubstance abuser is most likely to be responsible for withdrawal symptoms requiring both medical intervention and nursing support?
Barbiturates
A teaching need is revealed when a client taking disulfiram states A. "I usually treat heartburn with antacids." B. "I take ibuprofen or acetaminophen for headache." C. "Most over-the-counter cough syrups are OK for me to use." D. "I have had to give up using aftershave lotion."
C. "Most over-the-counter cough syrups are OK for me to use."
The most helpful message to transmit about relapse to the recovering alcoholic client is that lapses A. are an indicator of treatment failure. B. are caused by physiological changes. C. result from lack of good situational support. D. can be learning situations to prolong sobriety.
C. result from lack of good situational support.
What needs to be monitored before administering Lithium?
CBC (plasma levels), Renal (Renal changes over time-Nephrotoxicity), Thyroid (Decreased thyroids function over time)
A client is questioning the nurse about a newly prescribed medication, acamprosate calcium (Campral). Which is the most appropriate reply by the nurse?
Campral has been approved by the U.S. Food and Drug Administration (FDA) for the maintenance of abstinence from alcohol in clients diagnosed with alcohol dependence who are abstinent at treatment initiation.
Describe Catatonic schizophrenia
Catatonic: Motor immobility, rigid posture or excessive motor activity, including parrot-like repetition
Breaks with reality such as those experienced by clients with schizophrenia require the nurse to understand that:
Clients believe that what they feel that they are experiencing is real. Failure to accept the client and the client's fears is a barrier to effective communication.
A nurse evaluates a client's patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period. Which is the best rationale for assessing this client for substance dependence?
Clients who are dependent on alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control
Describe cocaine. What type of drug is it and how does it work?
Cocaine is a stimulant, high psychological dependence and no physical dependence, its found in coca leaves. creates a feeling of exhilaration and lasting euphoria.
What are the 4 general strategies for relapse prevention?
Cognitive and behavioral: 1. recognize and learn how to avoid or cope with threats to recovery 2. changing lifestyle 3. learn how to participate in society w/out drugs 4. secure help from others/social support
Anticholinergic Crisis Symptoms
Confusion, hallucinations, dilated pupils, blurred vision, facial flushing,dry mucous membranes, difficulty swallowing, fever, tachycardia, hypertension, decreased bowel sounds, urinary retention, nausea, vomiting, seizures, coma HOT as a hare, BLINd as a bat, MAD as a hatter, DRY as a bone
A client has been prescribed chlorpromazine (Thorazine) for the management of positive symptoms of schizophrenia. When the client reports difficulty sustaining an erection, the nurse:
Consults with his provider regarding alternative medication therapies Although erectile dysfunction can result from conventional antipsychotic medication therapy, the provider is often able to prescribe an alternative medication that will help manage the symptoms but is less likely to cause the dysfunction.
Define Rationalization
Creating reasonable and acceptable explanations for unacceptable behavior.
Define stage of change Action
Defining Characteristic: Begins to implement the solution or plan.
Define stage of change Maintenance
Defining Characteristic: Develops new behaviors to maintain changes and solution.
Define stage of change Pre-contemplation
Defining Characteristic: No awareness of problem or intention to make a change.
Define stage of change Preparation
Defining Characteristic: Window of opportunity when a client considers change & develops a commitment to action.
Define stage of change Relapse
Defining Characteristics: Resumption of problem: normal & expected.
A client who is dependent on alcohol and drinks several six-packs of beer daily tells the nurse "Alcohol is no problem to me. I can quit anytime I want to." The nurse can assess this statement as indicating
Denial
Describe Rohypnol. What type of drug is it and what does it do?
Depressant, club drug, also known as "roofies",muscle relaxant, loss of consciousness, inability to remember.
Bipolar 2 is characterized by what types of episodes predominately?
Depressive
Describe Disorganized schizophrenia
Disorganized: Illogical thought, incoherent speech, and inappropriate affect
Name 3 medications that are indicated for abstinence maintenance of alcohol?
Disulfiram (Antabuse), Naltrexone (Vivitrol), Acamprosate (Campral)
One of the most popular club drugs. Can cause hallucinations. Create euphoria and can Crete users to a dangerous level. Increases body temp to 108*.
Ecstasy
What is grandiosity?
Exaggerated belief in one's own importance, identity, or capabilities
The night nurse reports that a young client with paranoid schizophrenia has been awake for several nights. The day nurse reviews the client's record and finds that this client did not have an interrupted sleep pattern disorder before transfer from a private room to a four-bed room 3 days ago. What factor should the nurse identify as most likely related to the client's sleeplessness?
Fear of the other clients Because the client has paranoid feelings that other people are out to do harm, assignment to a four-bed room may be threatening.
An outcome for a manic client during the acute phase that would indicate that the treatment plan was successful would be that the client is ________________________?
Free of injury. Risk for injury is a diagnosis of high priority for manic clients because of their hyperactivity.
Which drug is most apt to have been ingested by a young woman who comes to the emergency department with the report that although she has no recollection of the incident, she believes she was sexually assaulted at a party?
GHB
A client is admitted for alcohol detoxification. During detoxification, which symptoms should the nurse expect to assess?
Gross tremors, delirium, hyperactivity, and hypertension
A client with the diagnosis of schizophrenia refuses to eat meals. Which nursing action is most beneficial for this client?
Having a staff member sit with the client in a quiet area during mealtimes By sitting with the client during mealtimes the nurse can evaluate how much the client is eating; this encourages the client to eat and begins the construction of a trusting relationship
In assessing a client diagnosed with polysubstance abuse, the nurse should recognize that withdrawal from which substance may require a life-saving emergency intervention? A. Dextroamphetamine (Dexedrine) B. Diazepam (Valium) C. Morphine (Astramorph) D. Phencyclidine (PCP)
If large doses of central nervous system (CNS) depressants (like Valium) are repeatedly administered over a prolonged duration, a period of CNS hyperexcitability occurs on withdrawal of the drug. The response can be quite severe, even leading to convulsions and death.
Name a Club drug, primarily used in veterinary medicine as an animal anesthetic.
Ketamine
Dystonia Nursing intervention
Immediate administration of Benadryl 25-50 mg IM
A client with catatonic schizophrenia who is in a vegetative state is admitted to the psychiatric hospital. The nurse identifies short- and long-term outcomes in the client's clinical pathway. What is the priority short-term outcome of care that the client should be able to attain?
Ingesting adequate fluid and food with assistance A client in a vegetative state may not eat or drink without assistance; fluids and foods are basic physiologic needs that are necessary to prevent malnutrition and starvation; therefore the intake of adequate fluid and food is a priority short-term goal.
Tardive Dyskinesia Symptoms
Initial stages are in facial-buccal area (lip smacking, sucking etc) Later stages: impairment of involuntary movement, constant motion, movements in trunk, rocking
A client with schizophrenia, paranoid type, is delusional, withdrawn, and negativistic. The nurse should plan to:
Invite the client to play a game of cards or board game. Activities that require limited interpersonal contact are less threatening.
Name a powerful animal anesthetic. Causes hallucinations and puts users in a dream-like state
Ketamine
What are the intended effects of the benzodiazepines for detoxification from alcohol?
Maintenance of patient's v/s, decrease risk of seizures, decrease intensity of withdrawal s/s.
Bipolar 1 is characterized by what types of episodes predominately?
Manic
What findings of NMS would be present on physical exam?
Mental status is ALWAYS altered, typically in form of delirium. Pt may become agitated/combative. May progress to stupor, obtundation, and coma Extreme muscular rigidity described as "lead pipe rigidity" • May also observe: Diaphoresis Sialorrhea Dysphagia
Withdrawal symptoms from opioids
Nausea, vomiting, abdominal cramps, lacrimation, salivation, gooseflesh
What is the difference between negative and positive symptoms of schizophrenia? Give examples of each.
Negative: When things get taken out of normal experience; flat affect, slowed movement or speech, social withdrawal. Positive: things added into a persons normal experience; hallucinations and dillusions, incoherent thinking.
CIWA (Clinical Institute Withdrawal Assessment)
Nine items scored 0-7, one item 0-4; maximum score = 67 score agitation, anxiety, tremor, nausea, orientation, headache, sweating, tactile, visual and auditory disturbances
Name dietary restrictions for MAOIs No tyramine! Avocados, fava beans, aged cheeses, chocolate, bananas, figs, ginseng, vasopressor agents, salami, pepperoni, sausage, red wines
No tyramine! Avocados, fava beans, aged cheeses, chocolate, bananas, figs, ginseng, vasopressor agents, salami, pepperoni, sausage, red wines
A client's admission diagnosis is paranoid schizophrenia. What classic 2 clinical findings should the nurse anticipate?
Prominent delusions Auditory hallucinations Prominent delusions are the essential feature of paranoid schizophrenia
While helping an addicted individual plan for ongoing treatment, which of the following interventions is the first priority for a safe recovery?
The client strives to maintain abstinence.
Naltrexone (Vivitrol) What is the indicated effect?
Pure opioid antagonist that supresses craving and pleasure of alcohol.
What should the nurse do when a client with the diagnosis of schizophrenia talks about being controlled by others?
React to the feeling tone of the client's delusion. Reacting to the feeling tone of the client's delusion helps the client explore underlying feelings and allows the client to see the message that his verbalizations are communicating.
Describe Residual schizophrenia
Residual: Partial remission after an acute episode, marked by negative symptoms
What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?
Risk for injury R/T central nervous system stimulation The priority nursing diagnosis for a client experiencing alcohol withdrawal should be risk for injury R/T central nervous system stimulation. Alcohol withdrawal may include the following symptoms: course tremors of hands, tongue, or eyelids; seizures; nausea or vomiting; malaise or weakness; tachycardia; sweating; elevated blood pressure; anxiety; depressed mood; hallucinations; headache; and insomnia
A client with the diagnosis of schizophrenia watches the nurse pour juice for the morning medication from an almost-empty pitcher and screams, "That juice is no good! It's poisoned." What is the most therapeutic response by the nurse?
Say, "You sound frightened. Is there something else I can give you to take your medication with? The response "You sound frightened" reflects the client's feelings and avoids focusing on the delusion; following up with "Is there something else I can give you to take your medication with?" encourages the client to take the medication.
What is the ethical obligation of the nurse who has seen a peer divert a narcotic compared with the ethical obligation when the nurse observes a peer to be under the influence of alcohol?
Supervisory staff should be informed as soon as possible in both cases.
Which client characteristic is an initial concern for the nurse when caring for a client with the diagnosis of paranoid schizophrenia?
Suspicious feelings
An adult with the diagnosis of schizophrenia is admitted to the psychiatric hospital. The client is ungroomed, appears to be hearing voices, is withdrawn, and has not spoken to anyone for several days. What should the nurse do during the first few hospital days?
Seek out the client frequently to spend short periods of time together. Seeking out the client frequently to spend short periods of time together will help the nurse establish trust without unduly increasing anxiety.
Name signs of lithium toxicity.
Slurred speech, hand tremor, weight gain, hypotension, kidney dysfunction, hypothyroidism
On the afternoon of admission to a psychiatric unit, an adolescent boy with the diagnosis of schizophrenia exposes his genitals to a female nurse. What should the nurse's immediate therapeutic response be?
Stating that this behavior is unacceptable When clients enter a new milieu, limits should be set on unacceptable behavior and acceptable behavior should be reinforced.
Parkinsonism Symptoms and Nursing implications
Symptoms re identical to symptoms of Parkinson's Intervention: treat with anticholinergic medication. Can increase confusion and psychosis
A client with schizophrenia is taking benztropine (Cogentin) in conjunction with an antipsychotic. The client tells a nurse, "Sometimes I forget to take the Cogentin." What should the nurse teach the client to do if this happens again?
Take a dose as soon as possible, up to 2 hours before the next dose. Taking a dose as soon as possible is the advised intervention when a dose is missed; interruption of the medication may precipitate signs of withdrawal such as anxiety and tachycardia.
Which side effect of antipsychotic medication is generally nonreversible?
Tardive dyskinesia
A client with chronic undifferentiated schizophrenia is receiving an antipsychotic medication. For which potentially irreversible extrapyramidal side effect should a nurse monitor the client?
Tardive dyskinesia Tardive dyskinesia occurs as a late and persistent extrapyramidal complication of long-term antipsychotic therapy.
A client with the diagnosis of schizophrenia is given one of the antipsychotic drugs. The nurse understands that antipsychotic drugs can cause extrapyramidal side effects. Which effect is cause for the greatest concern?
Tardive dyskinesia Tardive dyskinesia, an extrapyramidal response characterized by vermicular movements and protrusion of the tongue, chewing and puckering movements of the mouth, and puffing of the cheeks, is often irreversible, even when the antipsychotic medication is withdrawn.
The nurse believes that a client being admitted for a surgical procedure may have a drinking problem. How should the nurse further evaluate this possibility?
The CAGE questionnaire is a screening tool used to determine the diagnosis of alcoholism. This questionnaire is composed of four simple questions. Scoring two or three "yes" answers strongly suggests a problem with alcohol.
A client with paranoid schizophrenia tells the nurse, "My neighbors are spying on me because they want to rob me and take money." While hospitalized, the client complains of being poisoned by the food and of being given the wrong medication. The nurse evaluates the client's response to medications and therapy. Which assessment finding leads the nurse to conclude that the client's reality testing has improved?
The client eats the food provided on the hospital tray. Because the client was admitted while complaining that the food was poisoned, eating the food on the tray indicates that the client feels safe.
A client was in an automobile accident. Although he has the odor of alcohol on his breath, his speech is clear and he is alert and answers questions posed to him. The law enforcement officer requests that the emergency department staff draw a blood sample for blood alcohol level determination. The level is determined to be 0.30 mg%. What conclusion can be drawn?
The client has a high tolerance to alcohol.
Define Bipolar I Disorder?
The client has at least one episode of mania alternating with major depression.
Define Bipolar II Disorder?
The client has one or more hypomanic episodes alternation with major depressive episodes.
Which medication orders should a nurse anticipate for a client who has a history of complicated withdrawal from benzodiazepines?
The nurse should anticipate that a physician would order chlordiazepoxide (Librium) and phenytoin (Dilantin) for a client who has a history of complicated withdrawal from benzodiazepines.
A nurse is reviewing STAT laboratory data of a client presenting in the emergency department. At what minimum blood alcohol level should a nurse expect intoxication to occur?
The nurse should expect that 100 mg/dL is the minimum blood alcohol level at which intoxication occurs.
A client has a history of daily bourbon drinking for the past 6 months. He is brought to an emergency department by family who report that his last drink was 1 hour ago. It is now 12 midnight. When should a nurse expect this client to exhibit withdrawal symptoms?
The nurse should expect that this client will begin experiencing withdrawal symptoms from alcohol between 3 a.m. and 11 a.m. Symptoms of alcohol withdrawal usually occur within 4 to 12 hours of cessation or reduction in heavy and prolonged alcohol use.
During group therapy, a client diagnosed with chronic alcohol dependence states, "I would not have boozed it up if my wife hadn't been nagging me all the time to get a job. She never did think that I was good enough for her." How should a nurse interpret this statement?
The nurse should interpret that the client is using rationalization to excuse his alcohol dependence. Rationalization is the defense mechanism by which people avoid taking responsibility for their actions by making excuses for the behavior
A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 24 hours. Which client symptom should the nurse immediate report to the ED physician?
The nurse should recognize that high blood pressure is a symptom of alcohol withdrawal and should promptly report this finding to the physician. Complications associated with alcohol withdrawal may progress to alcohol withdrawal delirium and possible seizure activity on about the second or third day following cessation of prolonged alcohol consumption.
On the first day of a client's alcohol detoxification, which nursing intervention should take priority?
The priority nursing intervention for this client should be to administer ordered chlordiazepoxide (Librium) in a dosage according to protocol. Chlordiazepoxide (Librium) is a benzodiazepine and is often used for substitution therapy in alcohol withdrawal.
A nurse holds the hand of a client who is withdrawing from alcohol. What is the nurse's rationale for this intervention?
To assess for fine tremor
A nurse is interviewing a client in an outpatient substance-abuse clinic. To promote success in the recovery process, which outcome should the nurse expect the client to initially accomplish?
To promote the recovery process the nurse should expect that the client would initially correlate life problems with alcohol use. Acceptance of the problem is the first step of the recovery process.
A client with schizophrenia is actively psychotic, and a new medication regimen is prescribed. A student nurse asks the primary nurse, "Which of the medications will be the most helpful against the psychotic signs and symptoms?"
Ziprasidone (Geodon) Ziprasidone (Geodon) is a neuroleptic, which will reduce psychosis by affecting the action of both dopamine and serotonin.
When is lithium level considered to be toxic?
above 1.5 mEq/L
An appropriate long-term goal/outcome for a recovering substance abuser would be that the client will
abstain from the use of mood-altering substances.
Benzodiazepines are useful for treating alcohol withdrawal because they
bind to ã-aminobutyric acid-benzodiazepine receptors.
Which symptom would NOT be assessed as a positive symptom of schizophrenia? a. Delusion of persecution b. Auditory hallucinations c. Affective flattening d. Idea of reference
c. Affective flattening
Schizophrenia is best characterized as
deteriorating personality
The first-line drug used to treat mania is _________?
lithium carbonate (Lithium). Lithium, a mood stabilizer
A recovering alcoholic relapses and drinks a glass of wine. The client presents in the emergency department (ED) experiencing severe throbbing headache, tachycardia, flushed face, dyspnea, and continuous vomiting. What may these symptoms indicate to the ED nurse?
ngestion of alcohol while disulfiram is in the body results in a syndrome of symptoms that can produce a good deal of discomfort for the individual.
A client has been using cocaine intranasally for 4 years. Two months ago she started freebasing. For the past week she has locked herself in her apartment and has used $8000 worth of cocaine. When brought to the hospital she was unconscious. Nursing measures should include
observation for hyperpyrexia and seizures.
A client brought to the emergency department at the university hospital after PCP ingestion tries to run up and down the hallway. The nursing intervention that would be most therapeutic is
obtaining an order for seclusion and close observation.
The only class of commonly abused drugs that has a specific antidote is
opiates.
