Exam 1 Flashcards
NT for Alzeimers
ACH
NT for Parkinsons
Dopamine
PRIMARY NT for Depression
Serotonin
NTs for Anixety
Serotonin
Gaba
NorEpi
NTs for Schizophrenia
too much dopamine and glutmate
What can happen if you have too little dopamine for antipsychotic drugs?
meds result in loss of dopamine everywhere, tardive dyskinesia
Drugs for psychotic disorders work on what NT?
D2 (dopamine)
IM olanzapine should NOT be used with ______ together and need to be given at least 1 hour apart owing to FDA black box warning, from multiple case reports of cardiopulmonary arrest.
lorazepam
3 meds for emergencies
Haloperidol (Haldol)
Ziprasidone (Geodon)
Olanzapine (Zyprexa)
1st vs 2nd gen antipsychotics- movement disorder?
1st = higher rate EPS/ Tardive (d2) 2nd = Lower Rate of EPS (serotonin +d2)
What special testing/evaluation for we do related to movement for antipsychotic drugs?
AIMS testing
2nd generation antipsychotic has what kind of side effects?
metabolic side effects
Educate/monitor: BMI, Diabetes, weight gain, diet, exercise
Clozapine associated with risk for _______
and requires management within a lab monitoring program
agranulocytosis
What drugs causes neuroleptic malignant syndrome?
All antipsychotic drugs can cause NMS.
*more common in older meds
What can cause neuroleptic malignant syndrome? (aka we need to avoid these things to prevent it from happening)
Take a high doses of medication
Quickly increased doses
IM medications
Switch antipsychotic medications
s/s ofNeuroleptic Malignant Syndrome
High fever(102 to 104 F) Increased respirations Muscle stiffness Sweating Anxiety/changes in mental state Tachycardia Arrhythmia Alterations on blood pressure
- Serious symptoms: Kidney failure Heartand lung failure Hypoxia Aspiration Pneumonia Acidosis
3 NT for depression
Serotonin
Dopamine
Nor Epi
SSRI vs SNRI common side effects
SSRI: Nausea Insomnia Anxiety Tremors Sexual dysfunction
SNRI: Nausea Tired Fatigue Dry mouth
What causes serotonin syndrome?
too much serotonin
s/s of serotonin syndrome?
Mental status changes, autonomic hyperactivity, neuromuscular abnormalities (tremors, rigidity), hypothermia , dry mouth
how do we treat serotonin syndrome?
Stop the medication, provide supportive therapy, treat symptoms
therapeutic lithium levels ? toxicity?
therapeutic: 0.6-1.2
toxic: >1.5
Benzo’s vs antihistmine for treating depression- side effects?
Benzodiazepines (with caution) —> cognitive disinhibition, sedation, overdose can lead to CNS depression
Antihistamines (e.g. hydroxyzine) - sedation, not CNS depressant though
how does one stop taking benzos for anxiety?
taper, SSRI, NOT cold turkey! –> withdrawal
ADHD NT
Dopamine and NorEPi
2 main Side effects of ADHD meds?
**Anorexia
-**Restriction of affect (“zombie-look”)
Are ADHD meds controlled substance?
schedule II
ways to show we are engaged in active listening?
posture- lean forward, listen intently, don’t cross arms, face patient square on
______ interviewing identifies a motivation that helps someone get to and end goal
motivational
resiliency means we facilitate not
do everything for the person
Can a nurse do CBT with apatient?
NO! must have training
nurses can use therapeutic elements of CBT but not engage in therapy with patient
best model for mental health care?
integrated
primary vs secondary vs tertiary intervention
◦ Primary intervention, education, prevention
◦ secondary intervention, screening, have some concerns
◦ tertiary intervention, ongoing management
criteria for involuntarily committing someone?
◦ cant take care of yourself or risk to yourself or others
**dependent on state and hospital policies
what happens to patient rights when they are IVCed?
do not lose rights! still need to get consent, possibly through the court system
What kind of environment are nurses trying to create for patients?
safe, recovery oriented
what is focus on during a processing group?
acceptance, recovery environment, empathy, concern
Example:
◦ be careful not to laugh at front desk someone could be very sad or be on edge about this
- make sure everyone has time to talk
-do not engage in trauma experiences
what do we do when someone is having a delusion? what are we assessing for?
◦ don’t confront delusion but assess for safety - is voice telling you to hurt yourself or others?
‣ might have need for distraction or active listening
best way to prevent drama and trauma for patients?
relaxation
therapy vs therapeutic relationship?
therapeutic relationship= nurse can use respect and think of of person as a whole to build therapeutic relationship.
Therapy is a structured occurrence
considerations for restraints?
skin, food, hydration, toileting
reassess!
a tool to help maintain boundaries
put the focus back on patient- “lets talk about you and your needs.”
how do we provide culturally competent care?
◦ being knowledgeable, give patient choices/options, check with person to meet them where they are at
stigma is a ____ to mental health
barrier
