CMN 548 STUDY GUIDE MODULE 2 – DIAGNOSTIC
TESTING, COMPLETE SOLUTION
Differentials, and Treatment Planning
Reading/Study Guide
Diagnostic and Laboratory Testing
Dr. Baker PPT Presentation:
1. Why are labs/diagnostics done in psychiatry?
- Before Diagnosis
o Assess pt’s general health
o Screen for potentially treatable medical conditions that may contribute
toward a psychiatric presentation
o A baseline in case medication causes lab abnormalities
- After Diagnosis
o Rule out substance use issues
o Checking pt for renal or liver issues, or pregnancy
o Med compliance and therapeutic index
o Pharmacogenetics – how genes affect body’s response to meds
2. What are some psychiatric symptoms of hyperthyroidism (decreased TSH levels)?
• Anxiety, mania, psychosis
• Hypothyroidism s/s
• Depression or psychosis
3. What are some potential psychiatric symptoms associated with elevated
blood urea nitrogen (BUN) levels?
• Lethargy and delirium
4. What does the Venereal Disease Research Laboratory (VDRL) test?
• Test is performed in dementia pts
• Used to detect syphilis infection
• Long standing syphilis infection causes dementia like symptoms
Fischbach (2020):
5. Define: specificity, prevalence, and incidence. P 4-5
,• Specificity: refers to the ability of a test to correctly identify individuals who
do not have the disease
• Prevalence: refers to number of existing cases of a disease, at a specific period
of time, in a given population
, • Incidence: refers to number of new cases of a disease, during a specified period
of time, in a specified population or community
• Sensitivity: refers to the ability of a test to correctly identify individuals who
have the disease
6. What are some reasons test results are slightly higher than "normal"? 9
• lab equipment, age, gender, race, environment, posture, diurnal, and other cyclic
variations, foods, beverages, fasting or postprandial state, drugs, and exercise
can affect derived values.
7. What precautions should be taken with patients who has a latex allergy? 31
• FDA requires all latex containing products to display statement: “Caution:
this product contains natural rubber…”
• List of precautions page 31
8. Who would be high risk for latex allergies?
• Healthcare workers, rubber industry workers, family hx, pts with
multiple surgeries ex children with spina bifida
9. What should the psychiatric mental health nurse practitioner do in the
event of a possible latex allergy? 32
• 1. Airway management
• 2. Administration of oxygen
• 3. Volume expansion (IV LR or NS)
• 4. Epi IV
• 5. Steroids (PO or IV)
• 6. Diphenhydramine (PO or IV)
• 7. Aminophylline IV
10. What should be documented for a patient refusing lab work for a
medication with a narrow therapeutic range? 41
• Document pts reasons for refusing test along with other
pertinent information about the situation and who was given this
report.
11. What factors could potentially elevate red blood cell levels on a CBC? 87
• Primary
• Polycythemia vera
• Erythemic erythrocytosis
• Secondary
• Kidney dz
• Extrarenal tumors
• High altitude
• Pulmonary dz
• Cardiovascular dz
• Alveolar hypoventilation
• Hemoglobinopathy
TESTING, COMPLETE SOLUTION
Differentials, and Treatment Planning
Reading/Study Guide
Diagnostic and Laboratory Testing
Dr. Baker PPT Presentation:
1. Why are labs/diagnostics done in psychiatry?
- Before Diagnosis
o Assess pt’s general health
o Screen for potentially treatable medical conditions that may contribute
toward a psychiatric presentation
o A baseline in case medication causes lab abnormalities
- After Diagnosis
o Rule out substance use issues
o Checking pt for renal or liver issues, or pregnancy
o Med compliance and therapeutic index
o Pharmacogenetics – how genes affect body’s response to meds
2. What are some psychiatric symptoms of hyperthyroidism (decreased TSH levels)?
• Anxiety, mania, psychosis
• Hypothyroidism s/s
• Depression or psychosis
3. What are some potential psychiatric symptoms associated with elevated
blood urea nitrogen (BUN) levels?
• Lethargy and delirium
4. What does the Venereal Disease Research Laboratory (VDRL) test?
• Test is performed in dementia pts
• Used to detect syphilis infection
• Long standing syphilis infection causes dementia like symptoms
Fischbach (2020):
5. Define: specificity, prevalence, and incidence. P 4-5
,• Specificity: refers to the ability of a test to correctly identify individuals who
do not have the disease
• Prevalence: refers to number of existing cases of a disease, at a specific period
of time, in a given population
, • Incidence: refers to number of new cases of a disease, during a specified period
of time, in a specified population or community
• Sensitivity: refers to the ability of a test to correctly identify individuals who
have the disease
6. What are some reasons test results are slightly higher than "normal"? 9
• lab equipment, age, gender, race, environment, posture, diurnal, and other cyclic
variations, foods, beverages, fasting or postprandial state, drugs, and exercise
can affect derived values.
7. What precautions should be taken with patients who has a latex allergy? 31
• FDA requires all latex containing products to display statement: “Caution:
this product contains natural rubber…”
• List of precautions page 31
8. Who would be high risk for latex allergies?
• Healthcare workers, rubber industry workers, family hx, pts with
multiple surgeries ex children with spina bifida
9. What should the psychiatric mental health nurse practitioner do in the
event of a possible latex allergy? 32
• 1. Airway management
• 2. Administration of oxygen
• 3. Volume expansion (IV LR or NS)
• 4. Epi IV
• 5. Steroids (PO or IV)
• 6. Diphenhydramine (PO or IV)
• 7. Aminophylline IV
10. What should be documented for a patient refusing lab work for a
medication with a narrow therapeutic range? 41
• Document pts reasons for refusing test along with other
pertinent information about the situation and who was given this
report.
11. What factors could potentially elevate red blood cell levels on a CBC? 87
• Primary
• Polycythemia vera
• Erythemic erythrocytosis
• Secondary
• Kidney dz
• Extrarenal tumors
• High altitude
• Pulmonary dz
• Cardiovascular dz
• Alveolar hypoventilation
• Hemoglobinopathy
