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Last Minute Review for PMHNP/ 552 Q&A/ . $11.59   Add to cart

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Last Minute Review for PMHNP/ 552 Q&A/ .

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Last Minute Review for PMHNP/ 552 Q&A/ . · Stimulant abuse and ADHD= screen all kids (T/F) - Answer: True Suicide risk factors - Answer: ***Count risk factor -age 45 yrs of older if male -55 yrs or older is female -Male -Divorced/Single/Separated -White -Living alone

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  • September 15, 2024
  • 141
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • PMHNP
  • PMHNP
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Last Minute Review for PMHNP/ 552 Q&A/
2024-2025.
· Stimulant abuse and ADHD= screen all kids (T/F) - Answer: True


Suicide risk factors - Answer: ***Count risk factor


-age 45 yrs of older if male
-55 yrs or older is female
-Male
-Divorced/Single/Separated
-White
-Living alone



Page 1 of 141

,-Psychiatric disorder
-Substance abuse
-Physical illness


-Previous suicide
-Family hx of suicide


-Recent loss/death


Highest Suicide risk - Answer: -previous attempt
-elderly
-male
-Plan


Lithium (Li) - Answer: Normal: 0.6-1.2


Lithium toxicity can occur at 1.5 or higher


Gold standard for treating manic episodes


Has anti-suicide effects in bipolar


Neuroprotective tx of choice for Bipolar




Page 2 of 141

,Before Rx, Check: TSH, Creatinine,BUN, UA (4+ protein = kidney disease), HCG for
females of childbearing age (12-51 years)


Lithium s/e: hypothyroidism, find hand tremors, maculopapular rash, GI upset,
diabetes insipidus (polyuria, polydipsia), , T-wave inversions, leukocytosis
(increased WBC's), Ebstein anomaly
----- Ebstein anomaly (congenital heart defect), Do a pregnancy test!!




Dehydration can increase Li level


Hyponatremia can increase Li level


**Pt shows understanding if the say "I will take extra water with me on a hike"


Lithium toxicity - Answer: Lithium toxicity can occur at 1.5 or higher




-severe nausea, vomiting, diarrhea, confusion, drowsiness, muscle weakness,
heart palpitations, coarse hand tremors, unsteady walking (ataxia)


Intervention:
-D/C Lithium and check Li levels


Meds that increase lithium level by reducing renal clearance leading to toxicity:

Page 3 of 141

, ---kidney disease, NSAIDS, thiazides, ACE inhibitors (used for cardiac failure)


Women of childbearing should get what test before starting any AP - Answer: HCG


Clozaril reduces suicide risk in what disorder? - Answer: -schizophrenia


Neuroleptic Malignant Syndrome (NMS) - Answer: Caused by antipsychotics
-----such as haloperidol, fluphenazine, chlorpromazine, trifluoperazine, and
prochlorperazine
-Extreme muscular rigidity
-Mutism
-Hyperthermia
-Tachycardia


increased CPK (creatinine phosphokinase) d/t muscle contraction/muscle
destruction


-myoglobinuria d/t breakdown of muscle cells (RHABDOMYOLYSIS)


-INcreased WBC (leukocytosis)
-Increased LFT (liver function test)


Tx: D/C offending agent
-Bromocriptine -(Dopamine 2 agonist
-Dantrolene- muscle relaxant (for rigidity)

Page 4 of 141

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