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Chapter 2: Select Special Topics in Psychiatric-Mental Health Practice - ANSWER-
Clinical Decision Making Process - ANSWER-• ADPIE
-Assessment: 1st step, subjective and objective data
• Diagnosis: analysis, formulation of nursing diagnosis
• Planning: prioritizing problems, determining goals, plan of care
• Implementation: nursing action (rather than medical action)
• Evaluating: comparing outcomes, communicate and document findings
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Range?
Measures? - ANSWER-0-40 units/L
,0-40 units/L
Hepatocellular damage
Potentially elevated in valproate therapy, hepatitis, cirrhosis
Glutamyltransferase (GGT)
Alkaline phospatase (ALP)
Range?
Measures?
Examples? - ANSWER-0-30 units/L
30-120 international units/L
Cholestasis: bike flow, either extrahepatic or intrahepatic
Elevated in alcohol abuse.
Elevated in gallbladder disease, liver disease. Elevated with bone injury
Creatine Kinase (CK)
,Range?
Measures?
Examples? - ANSWER-0-139 units/L
Muscle Injury. muscle enzyme found in skeletal and cardiac muscle;
elevated blood levels associated with heart attack, muscular dystrophy, and
other skeletal muscle pathologies
Urea Nitrogen (BUN)
Creatinine - ANSWER-8-20 mg/dL
0.6-1.2 mg/dl
Kidney Function
Increased in impaired kidney function
Measured with lithium therapy
Creatinine is more sensitive and specific indicator of kidney disease than BUN.
Measured with lithium therapy.
, Glomerular Filtration Rate (GFR)
Range?
Measures?
Examples? - ANSWER->90mL/min.
The best measurement of kidney function.
the amount of filtrate formed per minute by the two kidneys combined
Elderly pts have 30% reduced because of decreased muscle mass
Generally no dose adjustments or contraindications with psychotropics when
GFR >60mL/min
Valproate and select epileptic drugs ex. Carbamazepine.
Lab testing?
Level?
Comment?
Discontinue when? - ANSWER-Liver pane (ALT, AST, ALP, bilirubin, albumin, total
protein), CBC, WBC, platelet count, serum hCG, valproate level.