180 - Mental Health Exam 1 Flashcards by Alayna Johnson

Describes certain settings/enviornments designed to help clients replace inappropriate behaviors w/ more effective personal/ psychosocial skills

Therapeutic tools include the use of eye contact, facial expressions, body movement, and other nonverbal behaviors

Therapeutic communication (milieu)

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What makes a patient a candidate for inpatient psychiatric admission?

Persons behavior becomes threat to themselves or others
People w/in the enviornment are not able/willing to support mentally troubled patient
Person Perceives himselves as unable to cope/ behavior control

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Inpatient services are provided for what 3 main groups of people?

People experiencing a crisis
People with acute mental or emotional problems
People with chronic mental illness

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Repeat inpatient admission
* AKA “revolving door syndrome” - especially schizophrenia & chemical use patients

Becomes a way of life for chronically troubled

Client feels like failure & providers are frustrated by failed past techniques

Primary reason for patient return to inpatient enviornment is due to noncompliance

Recidivism

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what is the goal of a therapeutic enviornment?

To provide protection, support, & education

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What happens in a therapeutic enviornment during an inpatient stay ?

Care providers assist clients in meeting needs

Clients learn to replace maladaptive behaviors

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What are the Maslow’s Hierarchy of Basic Human Needs in order?

Physiological needs
Security & safety
Love & belonging
Self-esteem
Self-actualization

Must meet basic needs to move to the next

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Focus on physical surroundings
* Breath, nourishment, hygiene, & enviornment

Encourage good hygiene

Physiological needs - Maslow’s Hierarchy

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Most important

Feeling of physical safety & ability to feel secure

security of a limited setting
* Depressed/ SI patients protect from self harm

Safety & security - Maslow’s Hierarchy

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Fulfilled w/in therapeutic setting through:
* Use of communication
* Social interactions
* Relationships

Need to be accepted & find a place in a group

Isolation of mental illness is intense

Love
& belonging - Maslow’s Hierarchy

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Must respect yourself before others can love & respect you
* Client needs to be involved

Expectations play role in development of personal needs

Self-esteem needs - Maslow’s Hierarchy

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Need to achieve ones full potential

Not everyone will become

Clients become better able to cope

Self-actualization needs - Maslow’s Hierarchy

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What are the 4 malpractice elements?

Duty of care

Breach of duty

Causation

Injury/ harm

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Described as power, privilege, or existence to which one has a just claim

Helps define social interactions bc they contain principles of justice
* Equal /fair tx applied to all citizens

Associated w/ obligations

Rights

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Right to respectful care, privacy/confidentiallity, continuity of care, & relevant info
* Right to examin bills, refuse tx, & participate in research

Patient Rights

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Rights relate to respect, safety, & competent assistance

Right to full & equal participation as member of health care team

Right to set standards for quality & develop policies that affect Pt care

Care provider rights

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Set of rules/values that govern right behavior

Reflects:
* Values
* Principles of right/wrong
* Purpose - To protect rights

Ethics

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Acts as guidlinges for standards of practice

Let public know what behaviors can be accepted from their HCP

Codes of ethics are based including the following:
* Autonomy
* Beneficience, justice
* Nonmaleficence
* Confidentiality, fidelity, veracity

Ethical Principles

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Provide information to patients, be truthful, & support your Pts, but consult the supervisor if any question of appropriateness arises

Code of ethics

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Dilemmas exist when there is uncertainty/ disagreement about moral principles related to corse of action
* arise when problems cannot easily be solved

Ethical conflict

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What criteria does a Pt need to make in order to be admitted to Psych?

Patient initiates request for mental health survice
* Considered voluntary admission
* Voluntary admitted Pts may legally discharge self whenever

Involuntary psychiatric admission provide a protected, theraputic enviornment
* Pt can stay from days to years

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What would the most common crime in a mental health care setting include?

Homicide, controlled substance violation, & theft
* Assult/battery
* Invasion of privacy
* False imprisonment

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What are the 7 Principles of Mental Health Care?

Do no harm
Accept Pt as whole person
Develop trust
Explore behaviors & emotions
Encourage responsibility
Encourage effective adaptation-crisis intervention
Provide consistency

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Avoid any action that may result in harm to your Pt

Relates to “reasonable & prudent nurse” (caregiver)

Do no harm

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Based on concept of “whole”
* Viewing Pts involves acceptance of their lifestyle, attitudes, social interactions, & living conditions

Holistic Health Care

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Mental health care providers encourage what?

One step at a time

Crisis intervention

Learning coping mechanisms

Recovery begins when attempts to cope with the problem result in success

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What should you do as the nurse during a crisis intervention?

Provide immediate attention / care

Control & assess

Pt’s dispossition is determined

Refferal & follow up

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How can you provide consistancy in mental health?

Being steady, regular, and dependable

Setting limits & focusing on the positive changes that patients are making

Addressed in POC

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How should you as the caregiver interact with a patient w/ mental illness?

Convey “ a consistent, thoughtful effort directed toward developing an awareness of self and others”

Approach must be monitored & adjusted continually

Role models for good mental & physical health
- serve as therapeutic instrument

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How can you as the care giver be self-aware of a patient with a mental illness?

Objectively look w/in

Oversee own growth & development

Allows individuals to direct & mold the pattern of their lives

Caregiver who encourages self-awareness must practice self-awareness

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Concern for the well-being of another person

Behaviors associated with:
* Accepting
* Comfort
* Being honest
* Listening attentively
* Having sensitivity

Caring

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The ability to recognize & share the emotions of another person w/o actually experiencing them

Empathy

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The ability to see clearly & understand the nature of things

Relies on common sense, good judgement, and prudence

Insight

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What is the difference between risk taking & failure?

Risk taking implies the possibility of failure

Failure provides the opportunity for change
* One only fails when one refuses to grow from the experience

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Receiving the entire person and the world in which s/he functions

Does not necessarily include approving behaviors

HCP must accept the entire person

Acceptance

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What are vital elemants of health care, but must be balanced by professionalism, judgment, & theraputic actions that meet Pt needs?

Acceptance

Compassion

Empathy

Tip: Think “ACE”

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A promise to do the best you can do in every situation & to be the best that you can be

Self-commitment

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How can you keep a positive attitude as a caregiver?

Listen to yourself talk

Change recurrent negative themes

Be own cheerleader

Visualize future successes

Act the part

Nurture yourself to be able to nurture others

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Energy exchanged between 2 people

A flow that moves patients toward constructive ways of thinking & effective ways of coping

Characteristics:
* Acceptance
* Rapport
* Genuineness
* Therapeutic use of self

Components (think TEACH):
* T = Trust
* E = Empathy
* A = Auonomy
* C = Caring
* H = Hope

Therapeutic relationship

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What are the 3 types of relationships?

Social relationship

Work relationship

Therapeutic relationship

made up of concepts trust, empathy, autonomy, caring, & hope

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What are the 5 dynamic components of a therapeutic relationship?

T = Trust
* Assured belief that others are capable of assisting in times of distress

E = Empathy
* Ability to walk a mile in anothers shoes

A = Autonomy
* Ability to detect & control one activities & density

C = Caring
* Energy that allows caregivers to unconditionally accept all people, even when they are most unlovable

H = Hope
* Expectation of acheiving a future goal
* Consists of 6 demensions - affective, affiliative, behavioral, cognitive, temporal, & contextual

The working phase of the theraputic process is:

A) The final phase

B) The phase where goals are acheived

C) The phase where Pt & caregiver become aqcuainted

D) Countertransference

A) The final phase

What are the 4 roles of the caregiver?

Change agent

Teacher

Technician

Therapist

Which of the following is not on of the 3 qualities of a therapeutic relationship?

A) Confidentiality
B) Acceptance
C) Rapport
D) Genuiness

B) Acceptance

What are the 3 characteristics of chronic mental illness?

Behavioral
* Unable to function socially / occupationally
* Assultive / criminal behavior may occur
* Increase sexual behavior / increased STI risk
* Violence

Physical
* Dress unusual / out of season
* Lacks personal hygiene
* Malnutrition
* Chronic medical conditions are common

Psychological
* Several intellectual, emotional, social, & spiritual features in common
* Chronic low self-seteem, depression, loneliness, & hopelessness
* Often see themelves as helpless, ineffective, & incapable of change

Children with ________ have problems with the intellectual & emotional aspects of life.

A) Autism
B) Mental retardation
C) Eating disorders
D) Schizophrenia

B) Mental retardation

Children with ________ are in a world of their own.

A) Autism
B) Mental retardation
C) Eating disorders
D) Schizophrenia

A) Autism

What is the most common aquired mental health problem in older adults?

Alzheimer’s diseases & other dementias
* Depression is another but less common

The presence of 2+ mental health disorders

Dual Dx

Comorbidity

When would an individual with a chronic mental health issue be hospitalized?

When their behavior poses a threat to themselves or others

How long is the average length of stay in an inpatient setting?

About 10 days

Where are many chronically mentally disordered clients discharged?

Halfway house or other group homes

Many live at home with their families

Offers opportunities for individuals with severe mental illness to meet their often neglected social needs

Uses special talents of physicians, psychologists, nurses, occupational & physical therapists, dietitians, and other specialists

Multidispilinary approach

What are therapeutic interventions designed on the basis of?

Identification problems

Available resources

Clients willingness to cooperate w/ therapeutic regimen

What data must the nurse gather when assessing a patient w/ a mental illness?

Thorough Hx

Physical status

Perceptions

Behaviors

A depressed patient appears disheveled, unkempt, and neglected. This aspect of the mental health assessment would include which of the following?

A) Emotional state
B) General description
C) Affect
D) Sensorium

B) General description

The nurse documents that a client is displaying a “flat affect”. The clients behavior most likely would consist of:

A) Rapid dramatic changes in emotion
B) Sadness & hopelessness
C) Lack of agreement of affect & mood
D) Unresponsive emotions

D) Unresponsive emotions

A Pt w/ seasonal affective disorder (SAD) may be treated successfully w/ which of the following body-based practices?

A) Acupuncture
B) Phototherapy
C) Chelation
D) Eye movement desensitization

B) Phototherapy

The absence of disparties / avoidable differences among socioeconomic & demographic groups / geographical areas in health status & health outcomes such as disease, disability, or morality

Ex:
* Lack of health insurance & high health care costs
* Language barriers, Lack of transportation
* Provider / Pt communication
* Biased clinical decidion making
* Pt’s mistrust & refusal
* Unequal pain management, palliative care & breast cancer screening
* Unequal early / adequate prenatal care, & recommended immunizations

HRSA
“Health disparties” / “Health equity”

Ineffective emotional states, ranging from deep depression to excited elation
* AKA - “ Affective disorder “ (Affective means emotions)

Disturbance in the emotional dimension of human functioning

Mood disorder

Increase certain neruotransmitter activities

Divided into categories based on chemical formula:
* Tricyclic, atypical
* Selective seretonin / norepinephrine reuptake inhibitor (SSNRIs), monoamine oxidase inhibitor (MAOIs)

Use:
* Bipolar, panic disorders
* OCD, ADHD
* Enuresis (bed wetting), bulimia
* Neuropathic pain, conduct disorders in children

Require 1- 4 weeks before relief is noted

S/s:
* Hypertensive crisist
* Headache, stiff neck, palpitations (toxicity)
* Dry mouth, nose, & eyes, urinary retention, sedation (Anticholergic reactions)

Interventions:
* Report any behavior / physical changes
* Protect from falls (postural hypotension)
* Repost S/s of toxicity
* Monitor kidney / liver function

Antidepressant medications

Why do antidepressants interact w/ other drugs?

They block the destruction of specific major transmitterrs
* higher levels of these chemicals circulate through the body

What are 3 interactions w/ monoamine oxidase inhibitors (MAOIs)?

Anticholergic reactions:
* Dry mouth, blurred vision
* Decreased tearing, urinary hesitancy / retention
* Constipation, excessive sweating

Hypertensive crisis:
* Throbbing, radiating headache, stiff neck
* Palpitations, chest tightness, severe HTN, tachycardia
* Dilated pupils, sweating

CNS depression:
* Change LOC, disorientation, confusion, agitation
* Sedation, hallucinations, low seizure threshold

What are side effects of Selective seretonin / norepinephrine reuptake inhibitors (SSNRIs)?

Dry mouth

N/V/D/C/A/H

Change in alertness

Increased sweating

Urinary & visual disturbances

Dizziness, Fatigue, weakness, tremor

What are some dietary interactions w/ monoamine oxidase inhibitors (MAOIs)?

AVOID:
* Beer/ ale, red wines, sherry wines, liqueurs,cognac (Alcohol)
* Aged cheese, sour cream (Dairy)
* Avocados, bananas, fava & broad beans, canned figs, & overriped fruit (fruits/vegs)
* Pickled/smoked/ tenderizer, bologna, ck/beef, liver, dried fish, salami meats, sauasages (salami meats)
* Large amounts of caffeinated coffee, tea, or cola
* Chocolate, licorice, soy sauce, yeast

What are some drug interactions w/ monoamine oxidase inhibitors (MAOIs)?

AVOID:
* prescription & OTC nasal sprays, sinus decongestions, cold/allergy/hay fever remides
* Inhalants for asthma
* Weight loss pills, pep pills, stimulants, local anesthetics
* Illicit drugs: Cocaine, any amphetamine (uppers), & narcotics

Depression in adolescence usually related to what 4 factors?

Self-esteem

Loneliness

Family strengths

Parent-teen communication

List the 3 reasons why teen depression must be recognized as serious:

Depression arising during adolescence tend to last

Have a high rate of recurrence

Associated w/ long lasting interpersonal problems

Which adults are at risk for depression?

women

People between ages 35-44

Whites & hispanics

Individuals w/ fewer than 12 years of school

People who live in major urban areas

People w/ physical illnesses

Recently widowed older adults

People who live in western U.S

What are some signals of depression in the elderly population?

Change in daily routine, eating, sleeping, or activity patterns

Decreased concentration, communication, & motivation

Feeling of envy, failure, indecisions, guilt & hopelessness

Loss of interest, self-confidence, & self-esteem

Worry or talk about death

An emotional state in which a person has an elevated, expansive, & irritable mood accompanied by a loss of identity, increased activity, & grandiose thoughts & actions

Seen in Bipolar disorders
* Bipolar 1 & 2
* Cyclothymic disorders

Can last 3 months
* If allowed to continue, delirium & death from exhaustion may result - eventually depression phase begins again

Hospitalization breaks the cycle

Mania

Feeling of sadness, disappointment, & despair

Classified into depressive episodes, depressive disorders, & dysthymia on time & recurring behavior patterns

Whole body illness that involves emotional, physical, intellectual, social, & spiritual disorders

Depression

Sudden/dramatic shift to emotional extremes

Emotional extremes of mania & depression
* Their thoughts, moods, & behaviors swing from normal to grandiose to depressed

2 types: 1 & 2

Bipolar disorder

Exaggerated sense of cheerfullness begins cycle the progresses to unstable “high of mania”
* Behaviors become more impaired

Still able to engage in daily living activities

Hypomania

Episodes of major depression alternating w/ episodes of mania
* **More severe **

Delusions, & hallucinations can occur

Bipolar 1

Associated w/ hypomanic moods that do not progress to full manic states, and are shorter than type 1

Often results in 1-2 weeks of severe lethargy, withdrawl, & melancholy, followed by several days of elevated ir irritable mood, constant activity, & risky decision making

Bipolar 2

What are the 3 levels of mania?

1. Hypomania
* Outgoing, happy-go-lucky, unconcerned about the feelings of others , increased motor activity & sexual drives; moves quickly from one topic to the next, becomes easily irritated ;decreased need for sleep

2. Mania
* “High” expansive , angers quickly, pressured speech, flight of ideas, delusions of persecution & grandiosity; dresses inappropriately (layers, bizarre outfits, excessive makeup & jewlery), inappropriate behaviors (meddles in affaris, spends money recklessly, ect), sexually driven, little sleep but still hyperactive

3. Delirium
* Period of extreme excitement, anger, elation; has grandiose or religious delusions, becomes disoriented, incoherent, agitated; may injure self or others; poor hygiene, disheveled, physically drained; death from exhaustion if mania goes untreated

Introduction of a controlled grand mal seizure by passing an electrical current through the brain

Works by raising the levels of the neurotransmitter norepinephrine (lower in people w/ depression)
* Tx 2-3x/week, takes about 15 min, 6-12 treatments over several weeks (out pt/ or in Pt)

Used only on clients w/ severe, long-lasting depression after attempts to stabilize the mood w/ various medications & therapies have failed

Common side effects: headache, confusion on awakening from the tx, short term amnesia, clients mood improves rapidly

Electroconvulsive Therapy (ECT)

Electroconvulsive Therapy (ECT) is not prescribed for what type of clients?

Recent MI/Heart attack

Heart disease

High/low BP

Stroke

CHF

Why: Tx lowers BP and slows HR

What Pt education & nursing interventions would you implement for Electroconvulsive Therapy (ECT)?

NPO 8 hours before treatment

Consent forms signed, remind client that confusion and memory loss are common after treatment

Baseline vital signs

Cardiac, BP, & O2 monitoring begins

Short acting muscle relaxants, sedatives, an anesthetics agents admin. IV

EEG

Think “SIG E CAPS”:
* S: Sleep disturbance
* I: Interest decreases in pleasure activities & sex
* G: Guilty feeling
* E: Energy decreases
* C: Concentration
* A: Appetite fluctuation
* P: Psychomotor function decreases
* S: SI

Depression assessment

What are tools to measure mental status?

Mini Mental State
* used to systematically and thoroughly assess mental status
* An 11-question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. maximum score is 30 & a score of 23 or lower is indicative of cognitive impairment

Neecham Confusion Scale
* developed as an instrument for rapid and non-intrusive assessment of normal information processing, early changes in information processing, and for documentation of confusional behavior, including delirium
* It can be scored by the nurse “at the bedside” in a manner similar to other nursing assessments. It makes maximum use of already collected data

Confusion Assessment method instrument
* a standardized evidence-based tool that enables non-psychiatrically trained clinicians to identify and recognize delirium quickly and accurately
* Allow for monitoring during/between shifts day-day/ long term
* Do not replace continuous monitoring & documentation of mental status

What are the 5 types of hallucinations?

Visual

Auditory

Tactile
* sensations of touch without any physical stimulus
* Patients with schizophrenia may sometimes experience the feeling of being kissed, the feeling of someone lying by their side or feelings an animal crawling on them

Olfactory
* Makes you detect smells that aren’t really there in your environment
* Consist of unpleasant smells: rotten fish or eggs, gasoline, excrement

Gustatory
* Cause tastes that are often strange or unpleasant
* Relatively common symptom for people with epilepsy and schizo.
* Often perceived as sour, bitter, or metallic

How does a physician select the appropriate therapy?

Pt hx of responce to previous antidepressant

Potential adverse reactions

Physiologic manifestations alleviated within first week of therapy

Psychological symptoms improve after 2-4 weeks

Prolonged action of norepinephrine, dopamine, & serotonin by blocking reuptake

Use:
* Antidepressants, phantom limb pain
* Chronic pain, post herpetic neuralgia
* Periphreal neuropathy

Adverse:
* Blurred vision, constipation, dry mouth/nose/throat (common)
* Parkinsonian, seizure activity, tachycardia (severe)
* HF, dysrhythmias, suicidal actions (severe)

Drugs:
* Amitriptyline (Elavil)
* Clomipramine (Anafranil)
* Doxepin (Silenor)

Tricyclin Antidepressants (TCA)

Blocks metabolic destruction of norepinephrine, dopamine, & serotonin neurotransmitters

Used when tricyclic antidepressant therapy is unsatisfactory

Avoid tyramine (pickled foods, yeast, nuts, processed meats ect), ages cheese, wine/alcohol
* causes HTN crisis

Used for:
* Atypical depression
* Panic disorder, & some phobias

adverse reaction:
* Orthostatic Hypotension
* Restlessness, agitation
* Blurred vision, constipation, urinary retention
* Dry mucosa of mouth, throat, & nose
* Malignant HTN (Severe)

Drugs:
* Phenelzine (Nardil)
* Tranylcypromine
* Selegiline (Emsam)

monoamine oxidose inhibitor (MAOIs)

Inhibits reuptake & destruction of seritionin from synaptic cleft, prolonging action of neurotransmitter

Use: Widley w/ antidepressants

Adverse:
* Restlessness, agitation, anxiety
* Insomnia, sedative effects
* GI effects, suicidal actions

Drug: Venlafaxine (Effexor)

Selective serotonin reuptake inhibitors (SSRIs)

Normal mental state/mood in those w/ bipolar disorder that is neither manic or depressive

Behavior examples:
* Not feeling good or bad
* Feeling “okay”

Euthymia

Prolonged emotional state influencing ones whole personality & life function

Behavior example:
* Good or bad/ likes or dislikes

Mood

Outward expression of ones emotions - observable

Behavior example:
* Inappropriate response/action

Affect

Moderate depression for 2 years or more

S/s of depression

Negative POV of the world

Behavior example:
* Chronically sad, major depressive episode
* Self critical

Dysthymia

Focuses on helping clients w/ personal hygiene, maintaining adequate nutrition, & encouraging physical activities

PN responsibilities:
* Focus on personal hygiene, maintaining adequate nutrition, & encourage physical activity
* Maintain SI precautions

Concepts:
* Adherence
* Stress & coping
* Functional ability

Physical realm

PN responsibilities:
* Care revolves around therapeutic relationships
* Acceptance/trust/support
* Encouragement/emotional support to cope w/ problems

Concepts:
* Anxiety
* Mood & affect
* Self management

Emotional Realm

Extreme emotional response altering ones ability to think

PN responsibilities:
* Use gentle, nonjudgemental guidance when attempting to follow through on tasks
* Give instructions clear & slow (repeat if needed)
* Provide extra patience

Concepts:
* Cognition
* Psychosis
* Sleep

Intellectual Realm

Most individuals are lonely & afraid of associating w/ others
* involves spiritual realm

PN responsibilities:
* Stabilize moods w/ medications
* Gental encouragment to begin intercating w/ others

Concepts:
* Anxiety
* Family Dynamics
* Stress & coping

Social Realm

Antimanic
* Naturally occuring salt
* Once Pt is no longer manic, the need for drug drops dramatically

Interaction between the level in the blood & common table salt

Theraputic level: 0.6-1.2 mEq/L (MV-250)
* Always be aware of level prior to admin

Actions:
* Replaces intracellular & intraneuronal sodium
* Stabilizes neuronal membrane
* Reduces release of norepinephrine & increase uptake of tryptophan
* Exact action unknown

Uses:
* Mania
* Prevention of recurrent cycles

Premedication assessment labs, electrolytes, glucose, BUN/Cr, UA, thyroid function

Lithium

What are side effects and interventions of Lithium?

Side effects:
* Abd. discomfort, N/D/A, soft stool, cramps
* Edema (feet especially)
* Hair loss, hypothyroidism
* Muscle weakness, fatigue
* Polyuria (can progress to diabetes insipidus),
* Thirst, tremors, weight gain

Interventions:
* Give Lithium w/ food or milk
* Reassure s/s are temporary
* Check salt restrictions w/ Dr.
* Obtain thyroid function test
* Monitor I/O (report if >3000Ml/24 hr)
* Encourage to quench thirst, eliminate caffeine
* Moderatly restrict calories, reassure weight gain is common

What are S/s of lithium toxicity?

Mild - Blood serum level 1.5mEq/L
* Apathy, sluggishness/drowsines /lethargy
* Diminished concentration, mild incoordination
* Muscle weakness, muscle twitches, course hand tremor

Moderate - Blood serum level 1.5-2.5mEq/L
* N/V/D, Apathy
* Slurred speech, blurred vision, tinnitus
* sluggishness/drowsiness/lethargy, muscle weakness
* Irregular tremors, ataxia, frank muscle twitching

Severe - Blood serum level 2.5mEq/L
* Irregular muscle tremors
* hyperactive deep tendon reflexes
* Oliguria, dereased urine O/P
* Severe LOC changes, hallucinations
* Grandmal seizures, coma, death

Anticonvulsants - PO/ IV

Decreases seizures

Use:
* Simple/complex/absent/ mixed sizures
* Bipolar episodes, ADHD, Schizo.

Side effects:
* N/V/D/C/A, Rash
* Sedation

Adverse:
* Coma
* SI
* Hepatotoxicity

Interventions:
* Assess seizure disorder & mental status
* Blood studies (Hct, HB, RBC, PT/PTT, platelets)

Valproic Acid (Depakene)

Antidepressant - PO
* SSRI

Potent inhibitor of neuronal serotonin & norepinephrine uptake

Use: Prevention/Tx of major depression

Adverse:
* SI, SJS
* Tachycardia
* Angioedema

Interventions:
* Mental status
* Blood studies (CBC, WBC, Cardiac enzymes)

Venlafaxine (Effexor XR)

Antipsychotic - PO/IM

Exact mech. unknown

Uses:
* schizo., bipolar disorder
* Mania, major depressive disorder

Adverse:
* Seizures
* SI
* Tachycardia, agranulocytosis

BBW: assess mental status before use

Interventions:
* Take BP, RR, & HR Q4h during initial tx

Aripirazole (Abilify)

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180 - Mental Health Exam 1 Flashcards

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