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Nurs 663 exam 1 questions and answers
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Nurs 663 exam 1 questions and answers Nurs 663 exam 1 questions and answers Nurs 663 exam 1 questions and answers
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Nurs 663 exam 1what are modifiable risk factors for suicide? - ANS - unrealistic expectations
perfectionism
poor coping skills
what are some warnings signs of suicide? - ANS ideation, substance use
purposelessness, anxiety, "trapped", hopeless
withdrawal, anger, recklessness, mood changes
what three classes of medication are used as mood stabilizers? - ANS lithium
anticonvulsants
antipsychotics
what medication can help reduce the risk of suicide? - ANS lithium
what symptoms of bipolar does lithium help? - ANS mania and depression
what blood tests need to be completed before starting lithium? - ANS kidney (creatinine), TSH, CBC,
pregnancy test
what is the goal blood trough level for lithium? - ANS 0.6 - 1.2 mEq/L
what are the most common side effects of lithium use? - ANS GI upset
weight gain
tremor
,hair loss/acne
can cause:
leukocytosis
polyuria/polydipsia secondary to ADH antagonism
thyroid abnormalities
what are the levels and signs of lithium toxicity? - ANS mild (1.5-2): lethargy, tremor, increased GI upset
moderate (2-2.5) confusion, nystagmus
severe (>2.5) convulsions, oliguria, renal failure, seizures
what type of change on ECG might you see with lithium overdose? - ANS T wave flattened
what birth defect might be present with lithium use? - ANS ebstein's anomoly
how do you treat lithium overdose? - ANS *dialysis*
sodium polystyrene sulfonate
what type of bipolar symptoms does valproic acid help? - ANS mania
- less effective with depression
what is the starting dose of lithium? - ANS 300mg BID or TID
, what types of bipolar patients might benefit most from valproic acid? - ANS rapid cycling
mixed
patient with comorbid anxiety
comorbid substance use
what lab tests should be monitored with valproic acid? - ANS LFT, CBC, pregnancy test
what supplement should be started in women of childbearing age who are taking valproic acid? - ANS
folic acid
what is the target blood level of valproic acid? - ANS 50-100 mcg/ml
what are side effects of valproic acid? - ANS thrombocytopenia, pancreatitis, weight gain, hair loss, GI
distress, cognitive dulling, neural tube defects in pregnancy
*weight gain and sedation
- watch for increase in ammonia and transaminitis
what two organs can be impacted by valproic acid? - ANS liver, pancreas
what birth defects might be observed with valproic acid? - ANS neural tube defects, cleft palate
what is the first line treatment for acute mania and mania prophylaxis? - ANS carbamazepine
what type of bipolar symptoms is carbamazepine best for? - ANS mania (rapid, mixed)
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