PMHNP Exam 2022(Verified) )
what level is lithium toxicity?
1.5
lithium commorbidities
1. epstein abnormality in babies
2. hyper or hypothyroid
depakote level toxicity symptoms
1. involuntary body movement
2. tremors
3. jumpy body
Question: if pt is on depakote or lithium (or any type o...
PMHNP Exam 2022(Verified) )
what level is lithium toxicity?
1.5
lithium commorbidities
1. epstein abnormality in babies
2. hyper or hypothyroid
depakote level toxicity symptoms
1. involuntary body movement
2. tremors
3. jumpy body
Question: if pt is on depakote or lithium (or any type of antipsychotic) and they
have elevated prolactin level, what should you do?
decrease
What happens when prolactin is elevated?
sexual side effects
.what is the most common side effect of tegretol.. other side effects?
steven johnson.
SIDE EFFECTS: Can cause aplastic anemia, agranulocytosis, hyponatremia
If pt does not respond to haldol.. and is still aggressive and violent, what do u
give next
give GEODON IM
What is the one you are most concerned about? in antipsychotics
: HIP-TO-WAIST syndrome (metabolic syndrome)
: If patient is a diabetic, what should you do? (antipsychotics)
: start on low dose
what do you need to monitor if you start them on Geodon
Heart palpitations and abnormal heart rate
Pt is on lithium and is treated by his rheumatologist for his rheumarthris. Dr
prescribed Indocin (NSAID). What happens?
Nsaid is inhibitor. It will sit on enzyme and not let lithium metabolize and will cause
toxicity.
ACT (assertive community treatment) model is used for what
schizophrenia
If it is experiencing positive symptoms, what part of brain?
Mesolimbic
What part of brain causes negative symptoms?
mesocortical
If you order a CT scan for schizo pt.. what will you most likely see?
increase in the ventricles
Most common presentation of MDD?
anhedonia
fda pediatric OCD? age and med
zoloft x>6
prozac x>7
, Luvox X>8
Clomipramine(tca) x> 10
Pt on SSRI lexapro, but is still feeling depressed
go up on lexapro
you need to order another medication as an adjunct... despite ssri not working.
what do u order?
abilify
wellbutrin contraindications
Any hx of seizure
Any cardiovascular problems?
Any eating disorder background
If pt is taking a MAOI, what do you have to tell them to avoid
aged cheese and wine
If you have a pt with panic attacks, what would be your choice of benzo?
ativan
If your pt was admitted to ER with a panic attack, what is the benzo injectable
they would get?
ativan
tx for social anxiety
1. propanolol
pt has social anxiety but also has asthma or COPD or any respiratory issues.
zoloft
hallmark of ptsd?
thoughts bring the pt back to trauma
best treatment for ptsd
guided imagery
ciwa scale and when to initate treatment
initiate tx 8>)
Normal 0-9
Mild 10-15
Mod 16-20
Severe 15-21
what are the alcohol mantainence craving?
acamprosate
naltrexone
d-isulfram(antabuse)
what to monitor in cows scale
yawning, sweating, tremors, bp
most common heroin symptoms
body ache, nasal drip, muscle spasm
: How long should the pt be clean on heroin before starting on suboxone?
12 hours
when to refer to therapy using becks
0-9
when to refer for therapy and meds
10-19
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