Exam (elaborations)
NURS 663 - EXAM QUESTIONS AND ANSWERS
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NURS 663 - EXAM QUESTIONS AND ANSWERS
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NURS 663 - EXAM QUESTIONS ANDANSWERS
Manic Episode - Answer--Elevated, expansive, or irritable mood for at least 1 week
-Usually hospitalization
-Severe impairment
-3 of the following symptoms (4 if the mood is only irritable):
D-distractibility
I-indiscretion or irresponsibility
G-grandiosity or inflated self-esteem
F-flight of ideas, racing thoughts
A-activity increased
S-sleep need is decreased
T-talkative, pressure of speech
DIGFAST - Answer-D-distractibility
I-indiscretion or irresponsibility
G-grandiosity or inflated self-esteem
F-flight of ideas, racing thoughts
A-activity increased
S-sleep need is decreased
T-talkative, pressure of speech
Hypomanic episode - Answer-Manic symptoms that don't meet full criteria
-Same symptoms but only 4 days instead of a week
-No hospitalization
-No severe impairment
Bipolar Type 1 - Answer-At least 1 manic episode (can have a major depressive
episode but not required)
Bipolar Type 2 - Answer-At least 1 hypomanic episode, and at least 1 major depressive
episode
-NO manic episodes ever
Cyclothymia - Answer-Less severe/intense bipolar
-At least 2 years, periods of hypomania and depressive symptoms
-Never without symptoms for more than 2 months
Dysthymia - Answer-Less severe MDD that's more chronic
-Always sad baseline
-Depressed mood for at least 2 years but not full MDD criteria (only 2 symptoms
needed)
-Never without symptoms for more than 2 months
, Major Depressive Disorder (MDD) - Answer--At least 2 weeks and is a change from
baseline
-At least 1 symptom is either depressed mood, or anhedonia (lack of interest/pleasure)
-4 or more other symptoms:
-Weight loss/gain, appetite change
-Psychomotor agitation/retardation
-Insomnia/hypersomnia
-Fatigue/lack of energy
-Decreased concentration
-Suicidal ideation
Bipolar - Rapid Cycling - Answer-4 or more mood episodes in a year
Treatment for Bipolar (quick list) - Answer-Mood stabilizers
1st choice - lithium
2nd - anticonvulsants (valproic acid, carbamezapine, lamotrigine)
3rd - antispychotics
Big things to know with mood stabilizers - Answer-Indicated for: bipolar, cyclothymia,
schizoaffective, impulse control, intermittent explosive disorders
-Check pregnancy test for all!
-Lab work for levels of most of the meds
-Steven Johnson's syndrome common side effect
-Tremors common side effect
-Liver or kidney toxicity (depending which med)
1st choice med for Bipolar - Answer-Lithium
2nd choice med for Bipolar - Answer-Anticonvulsants as mood stabilizers
Valproic acid
Lamotrigine
Carbamazepine
3rd choice med for Bipolar - Answer-Antipsychotics
Lithium - Indication - Answer-"Gold standard" treatment for bipolar depression
Manic episodes
Maintenance treatment for bipolar with history of mania - prophylaxis for manic AND
depressive episodes
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