unit 2-2

Question 1

schizaphrenia education

Answer 1

1. learn about the illness
2. develop relapse prevention plan
3. therapy
4. coping skills w plan
5. adhere to treatment
6. avoid alcohol and drugs
7. take care of self

Question 2

neuroleptic malignant syndrome

Answer 2

• hyperthermia and limb rigidty
• tachycardia, hyper-reflexia, rapid decline in mental status
• elevated CPK, hyperkalemic, hyponatremic, metabolic acidosis

Question 3

lithium and zyprexa

Answer 3

takes 7-14 days to reach therapeutic affect

-zyprexa is antipsychotic

Question 4

lithium levels- normal

Answer 4

0. 6-1.2- normal

- 7-14 days

Question 5

mild lithium toxicity-4

Answer 5

1. 5-2

- blurred vision, ataxia, tinnitus, persistent N/V/D

Question 6

moderate lithium toxicity-6

Answer 6

2. 5-3.5

- polyuria w dilute urine, increased tremors, muscle irritability, mental confusion, giddiness, psychomotor retardation

Question 7

severe lithium toxicity-7

Answer 7

> 3.5

-altered consciousness, nystagmus, seizures, coma, MI, cardiovascular collapse, death

Question 8

lithium education

Answer 8

toxicity, serum levels tested, maintain usual sodium intake, drink 2-3 literd a day, tell dr if pregnant

Question 9

lithium contraindications

Answer 9

cardiovascular disease

Question 10

manic distraction

Answer 10

can split staff

Question 11

hypomania

Answer 11

1. thinking- racing thoughts, grandious, heightened perception (distraction), poor judgement, elaborate schemes
2. mood and afect-euphoric w irritability, volatile and fluctuating
3. behavior-overactive, sexually provocative, financially extravagent, communication- incessant, crude, pressured, voracious appetite, unable to sleep
4. other- boundless self confidence, overly familiar w others, frequent clothing changes

Question 12

acute mania

Answer 12

1. thinking- flight of ideas intensifies, grandious plans out of touch w reality, delusions of grandeur, poor judgrment and concentration
2. mood and affect- increasing irritability and hostility, short periods of rage, rapid shift from docile to hostile
3. behavior- demands attention, speech is crude, profane, and sexual, assaultive outbursts, no time to eat or sleep, intense psychomotor act
4. other- disorganized and chaotic

Question 13

delerious mania

Answer 13

1. thinking- clouding of consciousness (stupor), religiosity, delusions of grandeur/persecution, hallucinations, totally out of touch w reality
2. mood and affect- euphoria moves to elation, mood extemely labile-high, irritable, sad, indifferent
3. behavior-frenzied and purposeless movement, agitation
4. other-high risk for exhaustion/death if not treated

Question 14

cyclothymic

Answer 14

milder form of mood cycling w hypomania and dysthymic

Question 15

nursing priority after ECT

Answer 15

re-orientation

Question 16

dysthymic do

Answer 16

• chronic depressed mood for most of the day for 2 years
• early, insidious onset
• depressed mood becomes part of personality

Question 17

antidepressants

Answer 17

4-6 weeks

Question 18

MAOI poor outcome

Answer 18

hypotensive crises-tyramines, no OTC drugs

Question 19

refeeding syndrome

Answer 19

the demands of a replenished circulatory system overwhelm the capacity of nutritionally depleted cardiac muscle which can lead to cardiac collapse
-cardiac dysrhythmias, severe hypotension, and bradycardia

Question 20

bulimia interventions

Answer 20

do not discuss food, accompany to bathroom,