NSG 240 EXAM 2 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NSG 240 EXAM 2 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 Lithium - Answers a salt that is prescribed for its ability to stabilize the mania associated with bipolar disorder Lithium therapeutic range - Answers 0.6-1.2 mEq/L Lithium acute mania - Answers 1.0-1.5 mEq/L Lithium lag period - Answers 7-10 days Lithium Impacts - Answers Drugs that increase or decrease serum sodium levels have impact of lithium levels Lithium Toxicity - Answers Tremors, Metallic taste, neuro symptoms besides parenthesia Lithium level monitoring - Answers Monitored once or twice a week after initial treatment until dosage serum levels are stable and then monthly during maintenance therapy. Blood samples drawn 12 hours after last dose Lithium toxicity 1.2 or 1.2 in elderly (most common 1.5) - Answers Early signs Vomiting, Diarrhea Lithium Toxicity 2mEq/L - Answers Tremors, Sedation, Confusion, Lithium Toxicity 3.5 mEq/L - Answers delirium, seizures, coma, cardiovascular collapse, death Lithium Toxicity Masking - Answers Chlorpromazine may mask early signs of lithium toxicity Nursing interventions for Lithium - Answers Instruct patients to report all medications, herbals, and caffeine use to physician or nurse practitioner to evaluate for drug interactions Encourage patients to maintain fluid intake at 2,000-3,000 mL/day and avoid activities in which excessive sweating and fluid loss are a risk because inadequate fluid intake can affect lithium levels. Patient teaching of Lithium - Answers Instruct patients about the importance of regular monitoring of serum lithium levels Lithium contraindications - Answers Cardiovascular disease Brain damage Renal disease Thyroid disease Myasthenia gravis Pregnancy Breastfeeding mothers Children younger than 12 years Increased suicide risk Lithium - Answers Assess for suicide risk regularly and inform patients of risks associated with anticonvulsants. Hyponatremia (Lithium) - Answers Instruct patients to maintain usual dietary intake of sodium. Assess for and educate patients to report any episodes of nausea, vomiting, headache, muscle weakness, confusion, seizures, because these may be signs of hyponatremia. Hypotension (Lithium) - Answers Monitor vital signs and instruct patients to report any symptoms of dizziness or palpitations Drowsiness (Lithium) - Answers Instruct patients to avoid driving or operating dangerous machinery when experiencing this side effect. Assess patients' mental status for level of alertness. Lithium administration - Answers take with milk and maintain sodium Divalproex Side Effects - Answers Abdominal pain, alopecia, asthenia, diarrhea, diplopia, dizziness, headache, nausea, somnolence, tremor, vomiting Divalproex Client education - Answers Divalproex sodium should be taken with food, so take your doses with a snack or just after you have had a meal. If you have been given delayed or extended release tablets, swallow them whole with a drink of water. Do not chew or crush the tablets because they have a special protective coating Lamotrigine (Lamictal) - Answers anticonvulsant/mood stabilizer Lamotrigine side effects - Answers ataxia, dizziness headache n/v/ anorexia diplopia, blurred vision abdominal pain, dysmenorrhea loss of coordination mood changes irritability insomnia depression Lamotrigine adverse effects - Answers Flu like symptoms, worsening depression or suicidal thoughts, or severe rash. Report any of these symptoms to Doctor immediately lamotrigine education - Answers Swallow the tablet whole and do not break, crush, or chew it. Carbamzepine (Tegretol) - Answers Anticonvulsant Na+ channel blocker GABAA agonist Carbamzepine Side Effects - Answers Dizziness, loss of coordination, problems with walking, N/V, and drowsiness Watch for changes in mental status Carbamazepine education - Answers Don't take with grapefruit juice Depression Predisposing Factors - Answers Genetic Biochemical Neuroendocrine Disturbances Substance Intoxication and withdraw Medication side effect Types of mood disorders - Answers Major depressive disorder (MDD) Bipolar I Bipolar II Dysthymia Cyclothymia Depression Interventions - Answers Major goal: increase self-esteem 2. Schedule activities of daily living ( structure activities for success) 3. Encourage appropriate amounts of sleep 4. Family or group therapy 5. Unconditional acceptance 6. Encourage expression of feelings Disruptive Mood Dysregulation Disorder - Answers a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood major depressive disorder - Answers A mood disorder in which a person experiences, in the absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities. 5 or more of the following symptoms: * Depressed mood, sad, empty, hopeless Irritability in child/adolescents * Anhedonia * Significant weight change * Sleep insomnia/hypersomnia nearly daily * Fatigue/anergia nearly daily * Psychomotor agitation/retardation * Excessive feelings of guilt or worthlessness. * Inability to think/concentrate/indecisive * Recurrent thoughts of death or suicidal ideation Persistent Depressive Disorder - Answers a form of depression that is not severe enough to be diagnosed as major depressive disorder, but is comparable in symptoms Similar s/sx to MDD but milder. Mood sad No psychosis Minimal impairment in social and occupational fx. Essential feature: chronically depressed mood (or irritable) for most of the day, more days than not for at least 2 yrs. Premenstrual Dysphoric Disorder - Answers a disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation Depressed mood Excessive anxiety Mood swings and decreased interest in activities. Occurs during the week prior to menses, Improves shortly after onset of menses. Subsiding in the week postmenses. Substance/Medication induced depressive disorder - Answers Substances that can induce a depressive disorder include alcohol, hallucinogens (including PCP), inhalants, opioids, sedatives, hypnotics and anxiolytics, and stimulants (including cocaine) electroconvulsive therapy (ECT) - Answers a treatment that involves inducing a mild seizure by delivering an electrical shock to the brain ECT - Answers Primarily used in the treatment of severe depression, Mania, Schizophrenia, and Psychosis patients Usually when drug therapy is unsuccessful ECT contraindications - Answers NO CONTRAINDICATIONS JUST HIGH RISKS! Increased intracranial pressure Recent MI or CVA Severe hypertension Aneurysm CHF ECT side effects - Answers temporary memory loss and confusion ECT risks - Answers mortality, permanent memory loss, brain damage Medication used before ECT - Answers Muscle relaxers atropine sulfate or glycopyrrolate (Robinul) given intramuscularly ordered to decrease secretions (to prevent aspiration) and counteract the effects of vagal stimulation (bradycardia) induced by ECT. Medication during ECT - Answers methohexital (Brevital) as preferable because it increases the duration of the seizure general anesthetics methohexital and propofol Muscle relaxant, usually succinylcholine chloride, is given intravenously to prevent severe muscle contractions during the seizure, thereby reducing the possibility of fractured or dislocated bones. SIGECAPS - Answers acronym for depression symptoms - S= Sleep disorder I= Interest deficit (anhedonia) G= Guilt (worthless, hopeless, regret) E= Energy deficit C= Concentration deficit A= Appetite P= Psychomotor retardation/agitation S= Suicidality Normal Grief Self esteem intact May openly express anger Experiences "good/bad" days Able to experience moments of pleasure Accepts comfort/support from others Maintains hope May express guilt over some aspect of the loss Relates feelings of depression to specific loss experienced May experience transient physicals symptoms - Answers Depression Disturbed self esteem Usually does not directly express anger Persistent state of dysphoria Anhedonia is prevalent