Exam 3

Question 1

Used to treat depression (treatment resistant)

Answer 1

MAOIs

Question 1

Used to treat depression and anxiety disorders

Answer 1

Tricyclics, SSRIs, SNRIs

Question 2

Used to treat insomnia

Answer 2

Benzodiazepines, Non benzodiazepine hypnotics

Question 3

Used to treat schizophrenia, manic episodes, aggression

Answer 3

Typical antipsychotics

Question 4

Used to treat schizophrenia, bipolar disorder, depression, Tourette’s syndrome, autism

Answer 4

Atypical antipsychotics

Question 5

Used to treat narcolepsy, ADHD

Answer 5

CNS stimulants

Question 6

A rare but potentially life threatening condition characterized by a severe reduction in WBCs. Early signs include fever, sore throat, and mouth sores.

Answer 6

Agranulocytosis, caused by clozapine

Question 7

Monitor complete blood count with differential regularly, obtain baseline CBC before starting medication, assess for signs of infection. If the absolute neutrophil count (ANC) is less than 1500/mm3 or if patient shows signs of agranulocytosis, discontinue medication and notify provider immediately.

Answer 7

Nursing interventions for agranulocytosis

Question 8

A group of movement disorders that can occur as side effects of antipsychotics medications, especially the typical high potency ones such as haloperidol. Early symptoms include restlessness, muscle rigidity, and tremors. Acute dystonia is a rapid onset of muscle spams. Akathisia is a feeling of inner restlessness. Parkinsonism is a set of symptoms that resemble Parkinson’s disease.

Answer 8

EPS, caused by antipsychotic medications

Question 9

Assess for early symptoms, monitor vitals and respiratory status, administer anticholinergic medications or benzodiazepines as ordered, and implement fall precautions.

Answer 9

Nursing interventions for extrapyramidal symptoms

Question 10

A movement disorder that can occur as a side effect of long term use of antipsychotic medications, especially the typical high potency ones such as haloperidol. Early symptoms include involuntary movements of the tongue, lips, and jaw, and may progress to involve the limbs and trunk.

Answer 10

Tardive dyskinesia, caused by long term use of antipsychotic medications

Question 11

Assess for early symptoms using the AIMS, monitor vitals and respiratory status, evaluate medication regimens regularly, and consider switching to a lower potency antipsychotic medication or discontinuing the medication if this develops.

Answer 11

Nursing interventions for tardive dyskinesia

Question 12

A rare but serious adverse drug reaction that can be caused by several classes of psychotropic medications. Early signs include nausea, vomiting, abdominal pain, fatigue, and jaundice.

Answer 12

Hepatotoxicity, caused by mood stabilizers, antipsychotics, and benzodiazepines

Question 13

Monitor liver function tests (LFTs) regularly, obtain baseline LFTs before starting medication, educate patients about the signs and symptoms, advise patients to avoid alcohol and other medications that damage this organ, and report any symptoms to the healthcare provider immediately.

Answer 13

Nursing interventions for hepatotoxicity

Question 14

A rare but potentially life threatening condition that can occur as a side effect of antipsychotic medications, especially the typical high potency ones such as haloperidol. Early symptoms include fever, muscle rigidity, altered mental status, and tachycardia.

Answer 14

Neuroleptic malignant syndrome, caused by antipsychotic medications

Question 15

Discontinue the medication, monitor vital signs and respiratory status, implement cooling measures, administer muscle relaxants, anticholinergics, and benzodiazepines as ordered, and provide emotional support and reassurance.

Answer 15

Nursing interventions for neuroleptic malignant syndrome

Question 16

A rare but potentially life threatening condition that can be caused by several classes of psychotropic medications. Early symptoms include agitation, confusion, tachycardia, hyperthermia, diaphoresis, myoclonus, and shivering.

Answer 16

Serotonin syndrome, caused by antidepressants, atypical antipsychotics, certain opioids (tramadol and meperidine), and migraine medications (triptans)

Question 17

Discontinue the medication, monitor vitals and respiratory status, implement cooling measures, administer serotonin blocking medications, benzodiazepines, and supportive measures as ordered, educate patients about the importance of not taking multiple serotonergic medications or supplements, and monitor patients for at least 24 hrs after discontinuing serotonergic medications.

Answer 17

Nursing interventions for serotonin syndrome

Question 18

A rare but potentially life threatening skin reaction that can be caused by anticonvulsant medications such as lamotrigine. Early symptoms include flu like symptoms, rash, blistering, and mucous membrane involvement.

Answer 18

Stevens-Johnson syndrome, caused by mood stabilizers (lamotrigine and carbamazepine)

Question 19

Obtain baseline skin assessment and eye exams before starting the medication, monitor patients for signs and symptoms of rash and blistering, educate patients about the signs and symptoms of Stevens-Johnson syndrome and discontinue the medication and notify the provider immediately if symptoms occur.

Answer 19

Nursing interventions for Stevens-Johnson syndrome

Question 20

Tyramine sensitivity and hypertensive crisis from consuming foods that contain tyramine. Should avoid other antidepressants, over the counter cold medications, triptans, and meperidine. Causes serotonin syndrome and orthostatic hypotension.

Answer 20

MAOIs

Question 21

Anticholinergic effects, cardiotoxicity, lethal overdose, and orthostatic hypotension.

Answer 21

Tricyclics

Question 22

Sexual dysfunction, suicidality, serotonin syndrome, slow metabolism, stomach troubles, sodium levels decrease

Answer 22

SSRIs

Question 23

Discontinuation syndrome, serotonin syndrome, hypertension

Answer 23

SNRIs

Question 24

Dependence, withdrawal, sedation, drug interactions with other CNS depressants, opioids, alcohol

Answer 24

Benzodiazepines

Question 25

Dependence, sedation, drug interactions with other CNS depressants

Answer 25

Non benzodiazepine hypnotics

Question 26

Symptoms of toxicity include sedation and slurred speech, coarse hand tremors, ataxia, nausea, vomiting, diarrhea. Levels should never be greater than 1.5 mEq/L.

Answer 26

Lithium