1. Lithium: Mood stabilizer, used for treatment of bipolar disorder
Narrow therapeutic window
2. Lithium Levels: 0.4-1.0 therapeutic
1.5 mild toxicity
1.5-2.0 advanced toxicity
2.0- 2.5 severe toxicity
> 2.5 death
3. Signs & Symptoms of Lithium Toxicity: Thirst, Tremors, Vomiting, Diarrhea,
Muscle Weakness
4. Bipolar II Disorder: Episodes of hypomania (elation, high energy, but less than
bipolar I)
Does not experience psychosis
5. Bipolar I Disorder: Episodes of mania (super elation, super energy, doesn't
eat/drink/sleep, takes risks, spends excessive, hypersexual)
May have hallucinations
6. What is a priority when a Manic Bipolar I patient arrives at the ED?: 1.
Medically evaluate
2. IVF
2. Benzodiazepines
7. Nursing Interventions for Bipolar I Disorder: Limit Stimuli, Safety,
Encourage Sleep, Set Limits
8. Benztropine (Cogentin): Used for treatment of EPS, pseudo-parkinson
symptoms
9. Signs & Symptoms of Neuroleptic Malignant Syndrome: Muscle rigidity,
board-like, High temperature, diaphoretic, tachycardic
10. Generation Three Antipsychotics: Aripiprazole (Abilify)
Better side effect profile than generation one or two
Treats positive and negative symptoms of schizophrenia
11. Generation Two Antipsychotics (Atypical): First line treatment, less chance
of EPS
1/7
, .
Treats positive and negative symptoms of schizophrenia
12 Metabolic Syndrom: Occurs with generation two antipsychotics (atypical)
Weight gain, hyperglycemia, hyperlipidemia
13. Generation One Antipsychotics: Treats positive symptoms of schizophrenia
Extrapyramidal Side Effects
Chlorpromazine, Haloperidol, Fluphenazine
14. Catonia: Moves very little or not at all
Evaluate for hazards of immobility (edema, cyanosis, injury, skin impairment)
15. Nursing Interventions for Delusions: Do not say you believe the
delusion, don't try to talk the patient out of the delusion
Explore delusion and how they feel about it
If afraid of poisoning, let them eat prepackaged or wrapped food to establish trust
16. Paranoid Schizophrenics: Most Dangerous
If they feel that someone will harm them, they may assault them
You do not know whom they feel is harmful
17. Nursing Interventions for Hallucinations: Non-harmful: divert from
hallucination and focus of feelings
Command Hallucinations: Explore the hallucination and assess for safety ("What
are the voices saying? Do you recognize them?")
18. Delusions: A thought that is not based upon reality
Ex.) You feel that people are trying to hurt you
19. Illusions: You see/ hear something, but perceive it wrong
You see an IV pole and believe its a large snake.
2/7
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