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Nursing 103 > NU 103 Lecture 4 > Flashcards

NU 103 Lecture 4 Flashcards

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1
Q

AIMS?

A

Abnormal Involuntary Movement Scale.

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2
Q

Purpose of AIMS?

A

This tool is used to monitor involuntary movements and tardive dyskinesia in clients who take antipsychotic medication.

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3
Q

Extrapyramidal Adverse Effects

A

-Acute Dystonia
-Pseudoparkinsonism
-Akathisia
-Neuroleptic malignant Syndrome
-Tardive Dyskinesia (TD)

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4
Q

Acute Dystonia Timeline

A

1- 5 days after drug initiation.

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5
Q

Acute Dystonia Manifestations

A

Uncontrolled spasm of the tongue, neck, face, and back.

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6
Q

Pseudoparkinsonism Timeline

A

1-4 weeks after drug initiation.

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7
Q

Pseudoparkinsonism manifestations

A

Bradykinesia, Rigidity, and Tremors including pill-rolling.

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8
Q

Akathisia Timeline

A

5-60 days after drug initiation.

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9
Q

Akathisia Manifestation

A

Restlessness or Inability to sit or stand still.

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10
Q

Neuroleptic malignant Syndrome Timeline

A

Weeks to Months after Drug Initiation.

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11
Q

Neuroleptic malignant syndrome manifestations

A

Muscle Rigidity, Fever, Unstable BP, and/or myoglobinemia.

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12
Q

Neuroleptic malignant syndrome Nursing care

A

-Stop medication immediately
-Treat Symptoms

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13
Q

Tardive Dyskinesia (TD) Timeline

A

Months to years after drug initiation

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14
Q

Tardive Dyskinesia (TD) Manifestations

A

Involuntary painless movement of the face and upper limbs.

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15
Q

Most Significant Side Effects of the 1st generation antipsychotics?

A

Tardive Dyskinesia (TD)

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16
Q

When Assessing 1st generation medication always assess ?

A

Timeline

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17
Q

What can exacerbate Psychotic episodes?

A

Lack of Sleep

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18
Q

A NURSE IS DISCUSSING MANIFESTATIONS OF SCHIZOPHRENIA. WHICH OF THE FOLLOWING MANIFESTATIONS SHOULD THE NURSE IDENTIFY AS BEING EFFECTIVELY TREATED BY FIRST-GENERATION ANTIPSYCHOTICS? SELECT ALL THAT APPLY.

A. Auditory hallucinations
B. Withdrawal from social situations
C. Delusions of grandeur
D. Severe agitation
E. Anhedonia

A

A. Auditory hallucinations
C. Delusions of grandeur
D. Severe agitation

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19
Q

A NURSE IS CARING FOR A CLIENT IN AN ACUTE MENTAL HEALTH UNIT. THE CLIENT REPORTS HEARING VOICES THAT ARE STATING, “KILL YOUR DOCTOR.
WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE FIRST?

A. Encourage the client to participate in group therapy on the unit
B. Initiate one-to-one observation of the client
C. Focus the client on reality
D. Notify the provider of the client’s statement

A

B. Initiate one-to-one observation of the client

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20
Q

Psychotic Disorder Positive Symptoms

A

-Hallucinations
-Delusions
-Alterations in speech
-Bizarre behavior (walking backward constantly)
-Poor Judgement

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21
Q

Psychotic Disorder Negative Symptoms

A

-Affect
-Alogia
-Anergia
-Anhedonia
-Avolition

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22
Q

Most significant 1st generation medication?

A

-Haloperidol/ Haldol
-Chlorpromazine/ Thorazine

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23
Q

Selective Serotonin Reuptake Inhibitors (SSRI) main medications

A

-Fluoxetine/ Prozac
-Sertraline/ Zoloft

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24
Q

SSRIs expected pharmacological action?

A

-Have less side effects than SNRIs
-Selectively block the reuptake of the monoamine neurotransmitter serotonin in the synaptic space, thereby intensifying the effects of serotonin.

25
Q

Serotonin syndrome

A

-High levels of seratonin
-Can begin 2 to 72 hours after starting treatment and can be lethal.

26
Q

Serotonin syndrome Manifestations

A

“HARMFUL”
-Hyperthermia
-Anti-Cognitive
-Reflexes
-Myoclonus
-Fast Heart Rate
-Unconsciousness
-Loss of GI Control

27
Q

A nurse is assessing a client who has been taking sertraline for the past 2 days. The nurse should identify which of the following findings can indicate the client is developing serotonin syndrome.

A. Bruising
B. Fever
C. Tinnitus
D. Rash

A

B. Fever

28
Q

Tricyclic Antidepressants

A

-Intensified Effects of Neurotransmitter.
-It can take 4-8 weeks to kick in.

29
Q

Tricyclic Antidepressants Main Medication

A

Amitriptyline

30
Q

Tricyclic Antidepressants Uses

A

-Depression Disorder
-Bipolar
-Anxiety
-OCD & ADHD

31
Q

Tricyclic Antidepressants Contraindications

A

-Seizure Disorder
-Pregnancy Risk C
-Can Increase Suicide Risk

32
Q

Antidote for Serotonin Syndrome

A

-Cyropheptodine

33
Q

Tricyclic Antidepressants Main Complication

A

-Orthostatic Hypotension

34
Q

Monoamine oxidase inhibitors (MAOIs) main medications

A

-Nardil/ Phenelzine
-Selegiline/ Emsam

35
Q

Monoamine oxidase inhibitors (MAOIs) Uses

A

-Depression/ Anxiety
-Bulimia
-OCD & PTSD

36
Q

What can cause a Hypertensive Crisis when taking MAOIs?

A

-Tyramine

37
Q

A NURSE IS EDUCATING A CLIENT ON AMITRIPTYLINE. WHICH OF THE FOLLOWING STATEMENTS BY THE CLIENT INDICATES AN UNDERSTANDING OF THE TEACHING?

A.”| can expect to experience diarrhea while taking this medication”
B.”I may feel drowsy for a few weeks after starting this medication”
C. “I cannot eat my favorite pizza with pepperoni while taking this medication”
D. “This medication will help me lose the weight that I’ve gained over the last year”

A

B.”I may feel drowsy for a few weeks after starting this medication”

38
Q

A NURSE WORKING ON AN ACUTE MENTAL HEALTH UNIT IS ADMITTING A CLIENT WITH MDD AND COMORBID ANXIETY DISORDER. WHICH OF THE FOLLOWING ACTIONS IS THE NURSE’S PRIORITY?

A. Placing the client on one-to-one observation
B. Assisting the client to perform ADL’s
C. Encouraging the client to participate in counseling
D. Teaching the client about medication’s adverse effects

A

A. Placing the client on one-to-one observation

39
Q

Bipolar Disorder medications

A

-Mood Stabilizer/ Lithium

40
Q

Lithium Long-Term Treatment main complication?

A

-Hypothyroidism

41
Q

Lithium Toxicity Levels

A

-Common Adverse Effects
-0.6 to 1.2 mEq/L
-Early Indications
-1.5 to 2.0 mEq/L
-Advance Indications
-2.0 to 2.5 mEq/L
-Severe Toxicity
-Greater than 2.5 mEq/L

42
Q

Lithium Early Toxicity Indications Manifestations

A

-Confusion
-Sedation
-Coarse Tremors
-GI Distress

43
Q

Lithium Early Toxicity Level Nursing Care

A

-Excretion needs to be promoted
-Withhold medication
-New dosage can be administered based on blood lithium or sodium levels.

44
Q

Lithium Advance Toxicity Indications Manifestations

A

-Extreme Polyuria
-Blurred Vision
-Ataxia
-Seizures
-Severe Hypotension

45
Q

Treatment for Serotonin Syndrome

A

-Benzodiazepines

46
Q

Lithium Advance Toxicity Level Nursing Care

A

-Gastric Lavage

47
Q

Lithium Severe Toxicity Manifestations

A

-Coma and Death

48
Q

Lithium Severe Toxicity Nursing Care

A

-Hemodialysis

49
Q

After what treatment we use Lithium/ Mood stabilizers?

A

-Electroconvulsive Treatment (ECT)

50
Q

Lithium Client Education

A

-2 to 3 grams of sodium a day.
-2 to 3 liters of water a day.

51
Q

Mood-stabilizing antiepileptic/ Anticonvulsant medications?

A

-Carbamazepine
-Valproate
-Lamotrigine

52
Q

Mood-stabilizing antiepileptic/ Anticonvulsant medication Purpose?

A

-Suppress CNS excitation.
-Prevent Relapse of Manic/ depressive
-Mixed mania
-Rapid Cycling-DIsorder

53
Q

Carbamazepine Complications/ manifestations

A

-Blood Dyscrasias
-Leukopenia (WBC)
-Increase Infections
-Fluid Overload
-promotes ADH
-Skin Disorders
-Stevens-Johnson Syndrome

54
Q

Carbamazepine Considerations

A

-Interacts with BCP & Warfarin/Coumadin
-Avoid grapefruit juice
-4-12 mcg/mL

55
Q

Valproate Considerations

A

-Other anticonvulsants decrease effect.
-50-120 mcg/mL

56
Q

Valproate Complications/ Manifestations

A

-GI effects
-Nausea, Vomiting
-Hepatotoxicity
-Pancreatitis
-Thrombocytopenia
-Increase in bleeding

57
Q

Valproate Nursing Care

A

-Educate on Jaundice
-Liver Function at baseline and routine.

58
Q

A NURSE IS PLANNING CARE FOR A PATIENT WITH BIPOLAR DISORDER AND IS EXPERIENCING A MANIC EPISODE. WHICH OF THE FOLLOWING INTERVENTIONS SHOULD THE NURSE INCLUDE IN HER PLAN OF CARE? SELECT ALL THAT APPLY.

A. Provide flexible client behavior expectations
B. Offer concise explanations
C. Establish consistent limits
D. Disregard client concerns
E. Use a firm approach to communication

A

A. Provide flexible client behavior expectations
B. Offer concise explanations
C. Establish consistent limits
D. Disregard client concerns
E. Use a firm approach to communication

Nursing 103 (4 decks)

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