Exam (elaborations)
Maryville NURS 663 Exam 2 – Qs And As
Maryville NURS 663 Exam 2 – Qs And As
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Maryville NURS 663 Exam 2 – Qs And AsLithium labs ✔️Ans - level, NA, Ca, P, EKG, Creatinine, Urinalysis, CBC,
TSH
bipolar meds: depression ✔️Ans - lurasidone (13+), olanzapine +
fluoxetine (10+)(symbyax)
bipolar acute and mixed mania ✔️Ans - aripiprazole, risperidone,
olanzapine (13+), quetiapine (acute only), asenapine (10+)
classic mood stabilizers ✔️Ans - Lamotrigine (excellent medication to
use), lithium, Depakote (avoid in females if possible due to PCOS and
Pregnancy), Tegretol, Trileptal (no evidence for true Bipolar disorder)
anti-depressants ✔️Ans - class not used w/bipolar disorder
lithium ✔️Ans - Anti-manic, antidepressant, anti-suicidal
Lithium side effects ✔️Ans - Frequent urination, increased thirst,
weight gain, sedation
lithium toxicity ✔️Ans - sudden onset tremors, N/V/D, muscle
weakness, slurred speech, confusion, seizures (slowing down, feel really
out of it)
Persistent Motor or Vocal Tic Disorder ✔️Ans - pt in front of you only
has one or the other but not both—they usually don't even know it is a tic,
it is only meaningful if it's affecting their quality of life
Tourette's d/o ✔️Ans - Multiple motor and at least one vocal tic (some
tics come and go, they don't have them all at the same time to receive the
diagnosis)
HRT ✔️Ans - habit reversal training can be used to manage tics
Tics tx ✔️Ans - Alpha agonists (clonidine, guanfacine); Haldol is not the
first-line txt
,Developmental Coordination Disorder ✔️Ans - a motor disorder
characterized by marked impairment in the development of motor
coordination; movement isn't consistent w/age
Stereotypic Movement Disorder ✔️Ans - a motor disorder
characterized by repetitive, seemingly driven, and apparently purposeless
motor behavior, such as hand waving or head banging, but not include ASD
sx
Specific Learning Disorders ✔️Ans - difficulties in the acquisition and
use of listening, speaking, reading, writing, reasoning, or mathematical
abilities; dx by other professionals w/specialized training; NP tx comorbid
d/o
Anorexia nervosa ✔️Ans - an eating disorder in which an irrational fear
of weight gain leads people to starve themselves; restrictive or
binge/purge/exercise
Bulimia nervosa ✔️Ans - an eating disorder characterized by episodes
of overeating, usually of high-calorie foods, followed by vomiting, laxative
use, fasting, or excessive exercise
Binge-eating disorder ✔️Ans - significant binge-eating episodes,
followed by distress, disgust, or guilt, but without the compensatory
purging, fasting, or excessive exercise
Avoidant/restrictive eating disorder ✔️Ans - avoiding or restricting
foods in childhood. significantly low BMI; no distortion of body image or
fear of gaining wt. r/o delusions around food
Pica ✔️Ans - an abnormal craving or appetite for nonfood substances,
such as dirt, paint, or clay that lasts for at least 1 month; decrs incidence
with incr age
Feeding and Eating Disorders tx ✔️Ans - Talk therapy (counseling is
needed for the distress) (intensive outpatient, partial inpatient or actual
inpatient admission may be needed); most have associated depression
and/or anxiety
, Feeding and Eating Disorders meds ✔️Ans - fluoxetine help but not
direct tx
Vyvanse approved for binge eating but not because of stimulant effects
Encopresis ✔️Ans - a childhood disorder characterized by repeated
defecating in inappropriate places, such as one's clothing
Enuresis ✔️Ans - involuntary urination
Encopresis Treatment ✔️Ans - Behavior management: toilet refusal
behavior, scheduled toileting time, incentives.
Prevention of constipation
Counseling
Enuresis treatment ✔️Ans - 1. First line is behavioral interventions:
bed alarms, toileting at bedtime and during the night, bladder training
2. reassurance, resolves spontan, normal 4-5 yo
Enuresis meds ✔️Ans - Desmopressin nasal spray;
Major Depressive Disorder Dx ✔️Ans - 5+ for at least a 2-week period;
either #1 or 2 req
1. Depressed mood most of the day, nearly every day (can be irritability in
children & adolescents)
2. Diminished interest or pleasure in all, or almost all, activities
3. Change appetite/weight; kids not wt goals
Insomnia or hypersomnia nearly every day
4. Up or down Psychomotor
5. Fatigue or loss of energy
6. Worthlessness/excessive or inappropriate guilt
7. Diminished ability to think or concentrate, or indecisiveness (don't
confuse with ADHD, address mood first)
8. Recurrent thoughts of death, thoughts of suicide, or suicidal plan/intent:
if hosp then 2 wk not req.
SLAP ✔️Ans - Social supports; lethal; access to means; plan and
previous attempt
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