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PMHNP > NEED TO KNOW > Flashcards

NEED TO KNOW Flashcards

1
Q

Metoprolol (Lopressor) should not be used with (3)

A

Paroxetine, Fluoxetine, or Bupropion due to risk of serious adverse effects like hypotension and bradycardia

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2
Q

What supplements can improve depressive symptoms (4)

A

B12, B6, Folate, Omega 3 fatty acid

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3
Q

What medications can cause QT prolongation (4)

A

Ziprasidone
Quetiapine
Haloperidol
Citalopram

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4
Q

What medications are LESS Likely to prolong QT interval (3)

A

aripriprazole
lurasidone
olanzapine

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5
Q

Least sedating SSRIs (2)

A

Lexapro (escitalopram)
Fluoxetine

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6
Q

Safest SSRIs for patients with heart issues

A

sertraline
escitalopram

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7
Q

Symptoms of serotonin discontinuation syndrome (6)

A

muscle soreness
achiness
n&v
fatigue
lethargy
agitation

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8
Q

Effective tx for serotonin discontinuation syndrome

A

resume taking the antidepressant at the previously prescribed dose

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9
Q

Mood stabilizer with least weight gain

A

Lamictal

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10
Q

Migraine medications

A

Triptans and sumatriptan (imitrex)

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11
Q

What conditions present likely with homicidal ideation

A

Antisocial personality d/o very common

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12
Q

why do studies online show more efficacy for antidepressants with adults versus children

A

because studies contain more adults not children

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13
Q

Medications that can cause mania (4)

A

steroids like prednisone and dexamethason
Disulfiram (antabuse)
Isoniazid (INH)
Antidepressants for bipolar

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14
Q

Medications that can cause depression (9)

A

steroids **
liothyronine
beta blockers
interferon
Isotretinoin
retroviral drugs
antineoplastic drugs
benzodiazepines
progesterone

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15
Q

Paradoxical effects

A

prescribe patient with anxiety and agitation with Geodon, but instead of it helping the anxiety- it makes it worse- so patient is experiencing the opposite effect

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16
Q

Risk factors for osteoporosis 5

A

smoking, drinking caffeine, lack of calcium i diet, and vitamin D, lack of weight-bearing exercise

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17
Q

if pt has RA what is a common test

A

erythrocyte sedimentation rate

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18
Q

if pt is positive for RA what happens to teh erythrocyte sedimentation rate

A

increased

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19
Q

the infant is producing a shrill cry (high pitch) can be due to

A

can be due to increased intracranial pressure

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20
Q

postmenopausal women have low sex drive can be due to

A

hormonal decrease in testosterone, progesterone, and estrogen, and reduced pelvic blood flow

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21
Q

what hormonal therapy can help menopausal depression

A

estrogen and progesterone

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22
Q

what kind of diet helps with depression

A

low fat diets

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23
Q

who is more prone to alcohol related liver damage

A

women because they have lower levels of alcohol dehydrogenase, which is the enzyme that metabolizes alcohol

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24
Q

Macrocytic normachromic anemia you want to check

A

b12 and folic acid levels because b12 deficiency can lead to symptoms

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25
Q

major cause of microcytic anemia is

A

iron deficiency

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26
Q

what happens with low levels of iron

A

less oxygen gets to the cells keeping them from properly functioning and often leads to fatigue, weakness and anxiety

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27
Q

protects patients against unlawful hospitalization- esp mental illness, if they were hospitalized for no just reason they can use this to leave AMA

A

habeas corpus

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28
Q

in order to provide evidenced based care we need access to

A

current journal articles

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29
Q

you wanted the patient to review timeline but they couldn’t remember within a specific time frame what can you do

A

ask more specific questions or ask questions that link memorable events

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30
Q

if you wanted to educate patient about a medication you must first assess what

A

patients knowledge of the medication and their beliefs around it

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31
Q

disseminated encephalomyelitis symptoms

A

nervous system disorder- headache, confusion, ataxia, asymmetrical body movements

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32
Q

if patient has disseminated encephalomyelitis may need

A

neuroexam

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33
Q

if you are trying to implement a policy that will affect nurse practitioners nationwide you want to

A

create an online forum so questions and concerns can be addressed there

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34
Q

if you want to implement new policy but your coworkers are against the new policy what can you do

A

prove how the new policy can improve quality of patient care

35
Q

PICOT QUESTIONS stands for

A

Population problem patient
intervention issues interest
comparison
outcome
time

36
Q

starting investigation for nursing what should you do

A

start with PICOT question

37
Q

evidence from a systemic review or meta analysis of all relevant randomized controlled trials or evidence-based clinical practice guidelines based on a systematic review of RCTs or three or more RCTs of good quality that have similar results

A

level 1

38
Q

evidence obtained from at least one well designed RCT

A

level 2

39
Q

how to ensure continuous improvement of quality of care in an outpatient clinic

A

develop an instrument to monitor clinical outcomes

40
Q

how to ensure continuous quality improvement when treating patients with mental illness like depression and anxiety

A

use a rating scale to determine baseline scores and at regular intervals during treatment

41
Q

how to monitor clinical progress

A

standardized rating scales

42
Q

Diabetic keto acidosis is common complication of type 1 dm symptoms:

A

kussmaul respirations rapid and deep
fruity-scented breath
excessive thirst and urination
fatigue
confusion

43
Q

medication for enuresis

A

desmopressin to reduce urine production

44
Q

night time bedwetting non pharmacological interventions

A

set alarm for night time voiding and use moisture alarms

45
Q

looking up patients info on social media is

A

violating their trust

46
Q

patient has been taking a medication and is stable but then FDA releases a black box warning of medication so waht do you do

A

research benefits and risks of continued use and make decision with patient

47
Q

off label you want to make sure to provide patient with

A

FULL DISCLOSURE add evidence supporting of off label use document risks and pros

48
Q

sleep apnea risk factors

A

smoking,
excess weight
obesity
diabetes
high BP
narrowed airways

49
Q

reflective practicing

A

is a debriefing strategies after an event or cause with the goal of improving practice

50
Q

pt use to take on pill of clonazepam for two years but now is requesting two pills to achieve the same effect of the one pill

A

tolerance - decrease effect with continuous use of the SAME dose over time

51
Q

legal telemed

A

confidentiality concerns
medical errors
jurisdiction authority over licensure always verify where the patient is (if the client moves to another state in a state not under your license that is illegal)

52
Q

pt with Substance use disorder in IOP when do you transfer them to less IOP

A

patient is taking responsibility for their actions and has developed coping skills

53
Q

med errors what is the first thing you want to do to develop policy

A

assess common types of med errors and then assess learning needs of staff

54
Q

MMSE score

A

0-30

55
Q

MMSE mild score

A

21-24 Mild cognitive impairment possibly early to mild alzheimers

56
Q

MMSE Moderate score

A

10-20 moderate Alzheimer disease

57
Q

MMSE normal score

A

25-30

58
Q

MMSE severe score

A

0-9 severe alzheimer

59
Q

SLUM normal score

A

27-30

60
Q

SLUM mild score

A

21-26

61
Q

Slum dementia score

A

0-20

62
Q

MoCA normal score

A

26-30

63
Q

MoCa mild cognitive impairement

A

18-25

64
Q

moderate cognitive impairement MoCA

A

10-17

65
Q

MoCA less than 10 means

A

severe cognitive impairment

66
Q

if someone has Alzheimers they should not be scoring a

A

20-25 it should be reassessed

67
Q

PHQ moderate score depression

A

10-14

68
Q

HAM D moderate score depression

A

14-18

69
Q

MADRS moderate score depression

A

20-34

70
Q

Beck moderate depression

A

19-29

71
Q

HAM for anxiety moderate range

A

18-24

72
Q

GAD moderate

A

10-14

73
Q

COWS opioid moderate score

A

13-24

74
Q

when to start tx on COWS score

A

> 7

75
Q

CIWA ETOH moderate score

A

16-20

76
Q

when to start tx on CIWA

A

8 and above PRNS only

77
Q

when to start meds for CIWA score

A

15 and above (valium, Ativan, or librium

78
Q

what can you give patient scoring a mild on COWS 5-12?

A

clonidine

79
Q

when can you give buprenorphine or suboxone on COWS

A

moderate to severe 13 and above

80
Q

Suboxone is

A

buprenorphine and naloxone

81
Q

methadone can cause

A

cardiac issues not first choice

82
Q

clonidine common s/e

A

drowsiness more than buprenorphine or suboxone

83
Q
A

PMHNP (46 decks)

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