Nursing Process
Assess before intervention. Assessment is collecting data
Lithium level
0.6-1.2
lithum toxicity
Level of 1.5 or higher
What drug has been proven to have evidence of anti-suicidal effects
Lithium
What drug is gold standard for manic episodes
Lithium
...
Hematologic S/S of lithium toxicity - answer Leukocytosis (increased WBC)
What intervention should the PMHNP take if she suspects lithium toxicity - answer D/C and
check serum lithium levels
What drugs can cause a hypertensive crisis - answer Meperidine
,Stimulant's
and other sympathomimetics
Treatment for a hypertensive crisis - answer Administer phentolamine
Teratogenic risk of psych meds (HIGH) - answer Epstein anomaly from lithium
Spina bifida from Depakote
Backbox warming for mood stabilizer - answer Steven Johnson syndrome
S/S of Steven Johnson syndrome which can be a S/E of mood stabilizers - answer FEVER
Valproic acid can cause? - answer Hepatoxicity and pancreatitis
Carbamazepine (Tegretol) can cause Stevens Johnson syndrome in what ethnicity (HIGH) -
answer Asian population
What should you screen in the Asian population before starting Carbamazepine (Tegretol)
(HIGH) - answer HLAB-1502 allele
What should you check in females before starting Carbamazepine (Tegretol) - answer HCG
pregnancy
What supplement should be started in any female of child bearing age - answer Folic acid 0.4-
0.8 for neural tube development
For Clozaril and Carbamazepine monitor what labs? - answer WBC and ANC
D/C if ANC is <1000
, D/C id WBC is 2000-3000
Signs of agranulocytosis - answer fever, chills, sore throat, weakness
Normal BMI range - answer 18.5-24.9
With bulimia nervosa what can you see? - answer Normal BMI and erosion of dental
What are the s/s of anorexia nervosa? (HIGH) - answer Low BMI
Amenorrhea
Emaciation
Bradycardia
Hypotension
What SNRI can help with both pain and depression (HIGH) - answer Duloxetine
Clozaril is an an atypical antipsychotic that is metabolized by the? (HIGH) - answer Cytochrome
P450 enzyme and CYP1A2
If a patient starts smoking on carbamazepine what should the PMHNP do with the dose? (HIGH)
- answer Increase dose
Because this drug mixed with tobacco is an enzyme inducer which decreases serum level. If they
stop smoking decrease the dose.
Nsaids, thiazides, ace inhibitors and kidney disease may reduce renal clearance which in return
can? - answer Increase lithium levels by reducing renal clearance
Everything decreases in older adults except? - answer Body fat concentration increases
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