Exam 2

Question 1

Important action for staff members to take with people who have bipolar disorder

Answer 1

Set limits consistently
(They don’t have internal control so they need external control)

Question 2

Gold standard medication for people who have chronic suicidal thoughts

Answer 2

Lithium

Question 3

Early signs of lithium toxicity

Answer 3

GI upset
Coarse hand tremor
Confusion
Hyper-irritability of muscles
Electroencephalographic changes
Sedation
Incoordination

Question 4

Advanced signs of lithium toxicity

Answer 4

Ataxia
Giddiness
Serious electroencephalographic changes
Blurred vision
Clonic movements
Large output of dilute urine
Seizures
Stupor
Severe hypotension
Coma
Death is usually secondary to pulmonary complications

Question 5

Signs of severe lithium toxicity

Answer 5

Convulsions
Oliguria
Death can occur

Question 6

Side effects of lithium

Answer 6

Nausea
Vomiting
Diarrhea
Thirst
Polyuria
Lethargy
Sedation
Fine hand tremor
Renal toxicity
Goiter
Hypothyroidism may occur with long-term use

Question 7

Therapeutic blood level of lithium

Answer 7

0.6 to 1.2 mEq/L

Question 8

Maintenance blood level of lithium

Answer 8

0.4 to 1.3 mEq/L

Question 9

Toxic blood level of lithium

Answer 9

1.5 mEq/L and above

Question 10

When a patient leaves the hospital on lithium, what patient teaching should you do?

Answer 10

• tell pt what it’s for
• explain importance of returning to the clinic for lab draws
• adverse effects
• when they should call the Dr. For adverse effects/toxicity

Question 11

List the 3 mood stabilizers used for patients with epilepsy

Answer 11

Valproate (Depakote)
Carbamazepine (Equetro)
Lamotrigine (Lamictal)

Question 12

Side effects of second generation antipsychotics

Answer 12

Tendency toward weight gain that may lead to:
Insulin resistance
Diabetes
Duslipidemia
Cardiovascular impairment

Question 13

When someone has anxiety, what should they also be screened for?

Answer 13

Bipolar disorder because 75% of people with bipolar also have anxiety

Question 14

Disorder that tends to be very comorbid and hard to treat

Answer 14

Attention deficit disorder

Question 15

What should a nurse do if a patient is making them uncomfortable or mad?

Answer 15

Collaborate with other staff

Question 16

If someone is experiencing fatigue, what side-effect profile do we want to produce? And what is an example of a drug we would give?

Answer 16

Stimulate the CNS
Fluoxetine (SSRI)

Question 17

If someone is experiencing insomnia what type of side effect profile would we want to give? What is an example of a drug we would give them?

Answer 17

Substantial sedation
Mirtazapine (NaSSAs)

Question 18

If someone is experiencing sexual dysfunction, what type of side effect profile would we want to give? What is an example of a drug we would give them?

Answer 18

Enhance libido
Bupropion (NDRI)

Question 19

If someone is in chronic pain, what type of side effect profile would we want to give them? What is an example of a drug we would give them?

Answer 19

Relieve pain
TCAs or duloxetine (SNRI)

Question 20

What is the worst side effect of antidepressants and why?

Answer 20

Urinary retention because it effects the kidneys