NURS663 | NURS 663 Exam 2 Questions and Answers Graded A+
Pregnancy risks for meds - ANSWER-SSRIs generally okay
Depakote: for any woman of child bearing age
Mood stabilizers: cardiac anomolies, neural tube defects
Drugs in 3rd tri rarely teratogenic
Lithium uses - ANSWER-1. manic episodes of manic-depressive illness
2. maintenance treatment for manic-depressive pts with a hx. of mania
3. bipolar depression
4. MDD (adjunctive)
5. treatment -resistant depression
6. Reduces suicide risk
7. Works well in combination with atypical antipsychotics and/or mood stabilizing
anticonvulsants such as valproate
lithium common SE - ANSWER-1. tremor, ataxia, dysarthria, delirium memory
problems
2. polyuria, polydipsia,
3. diarrhea, nausea, vomiting
4. Weight gain
,Lithium: Life-Threatening SE's - ANSWER-1. toxicity
2. Renal impairment
3. Nephrogenic diabetes insipidus
4. Arrhythmia, CV changes, sick sinus syndrome, bradycardia, hypotension, T-wave
flattening and inversion
5. rare seizures
Lithium mgmt - ANSWER-1. Lower the dose
2. Take at night
3. Change to different preparation (e.g. controlled-release)
4. Reduce dosing from TID to BID
5. If toxicity symptoms- DISCONTINUE
6. Stomach upset- take with food
7. Tremor- avoid caffeine
8. May need to switch to another agent
Lithium lab monitoring - ANSWER-frequent _________levels-every 1-2 weeks until
desired serum concentration achieved, then every 2-3 months for 1st 6 months,
then every 6-12 months if remains stable
, lithium range - ANSWER-1.0-1.5 mEq/L for acute treatment and 0.6- 1.2 mEq/L for
chronic treatment
Megacolon - ANSWER-chronic rectal distention from large, hard fecal masses can
cause loss of tone in the rectal wall and desensitization to pressure
Encopresis dx - ANSWER-1. Repeated passage of feces into inappropriate places
(involuntary or intentional)
2. Occurs each month for at least 3 months
3. At least age 4 or equivalent developmental level
4. Behavior not attributable to substances or medical conditions except through a
mechanism involving constipation
Associative Looseness - ANSWER-Speech shifts to unrelated subjects. Pt. unaware
they are unconnected. When severe, speech may be incoherent
Neologisms - ANSWER-Invented meaningless words but are symbolic to pt
Concrete Thinking - ANSWER-Difficulty describing abstract sayings; "I'm climbing
the walls," or "It's raining cats and dogs." Takes things literally.
Clang Associations - ANSWER-Uses rhyming words; "I am cold and bold. The gold
has been sold."
Pregnancy risks for meds - ANSWER-SSRIs generally okay
Depakote: for any woman of child bearing age
Mood stabilizers: cardiac anomolies, neural tube defects
Drugs in 3rd tri rarely teratogenic
Lithium uses - ANSWER-1. manic episodes of manic-depressive illness
2. maintenance treatment for manic-depressive pts with a hx. of mania
3. bipolar depression
4. MDD (adjunctive)
5. treatment -resistant depression
6. Reduces suicide risk
7. Works well in combination with atypical antipsychotics and/or mood stabilizing
anticonvulsants such as valproate
lithium common SE - ANSWER-1. tremor, ataxia, dysarthria, delirium memory
problems
2. polyuria, polydipsia,
3. diarrhea, nausea, vomiting
4. Weight gain
,Lithium: Life-Threatening SE's - ANSWER-1. toxicity
2. Renal impairment
3. Nephrogenic diabetes insipidus
4. Arrhythmia, CV changes, sick sinus syndrome, bradycardia, hypotension, T-wave
flattening and inversion
5. rare seizures
Lithium mgmt - ANSWER-1. Lower the dose
2. Take at night
3. Change to different preparation (e.g. controlled-release)
4. Reduce dosing from TID to BID
5. If toxicity symptoms- DISCONTINUE
6. Stomach upset- take with food
7. Tremor- avoid caffeine
8. May need to switch to another agent
Lithium lab monitoring - ANSWER-frequent _________levels-every 1-2 weeks until
desired serum concentration achieved, then every 2-3 months for 1st 6 months,
then every 6-12 months if remains stable
, lithium range - ANSWER-1.0-1.5 mEq/L for acute treatment and 0.6- 1.2 mEq/L for
chronic treatment
Megacolon - ANSWER-chronic rectal distention from large, hard fecal masses can
cause loss of tone in the rectal wall and desensitization to pressure
Encopresis dx - ANSWER-1. Repeated passage of feces into inappropriate places
(involuntary or intentional)
2. Occurs each month for at least 3 months
3. At least age 4 or equivalent developmental level
4. Behavior not attributable to substances or medical conditions except through a
mechanism involving constipation
Associative Looseness - ANSWER-Speech shifts to unrelated subjects. Pt. unaware
they are unconnected. When severe, speech may be incoherent
Neologisms - ANSWER-Invented meaningless words but are symbolic to pt
Concrete Thinking - ANSWER-Difficulty describing abstract sayings; "I'm climbing
the walls," or "It's raining cats and dogs." Takes things literally.
Clang Associations - ANSWER-Uses rhyming words; "I am cold and bold. The gold
has been sold."
