PSYCHIATRIC NURSING QUESTION AND ANSWERS2 (
When to check blood levels of Lithium?
8-12 hours after taking, every week, then every 3 months
How do OTC medications interfere with lithium?
Interfere w/ excretion of Li, increases Li levels in blood
_________ are OTC medications that interacts with Lithium
NSAIDs
When can a patient take a missed dose of Lithium?
Within 2 hours
Lithium must be taken at the same time each day. T/F?
TRUE
Patient will need to stay _________ when taking lithium due to the inverse relationship of
lithium and __________
hydrated; sodium (Na)
How long does it take for lithium to "kick in?"
1 week
__________ is taken for acute mania and depression, it treats current symptoms and
prevents future relapse
Lithium (Li)
Medications for BPD I include:
Lithium, anticonvulsants, second-gen. antipsychotics
Therapeutic range for Lithium:
0.6-1.2 mEq/L
What is the toxic blood level for litium?
1.5 mEq//L & above
Contraindications for Lithium:
Kidney probs., diuretic use (excretion of Na, retention of Li), pregnancy, cardiovascular disease
What must assessed before lithium is administered?
,Creatinine levels
*can cause kidney probs
Side effects of lithium include
Fine hand tremor, mild thirst, mild nausea, GI discomfort (take WITH meals), mental confusion,
renal toxicity (long-term), acne, hair loss, muscle weakness
Signs of lithium toxicity include:
Coarse hand tremors, persistent diarrhea (GI upset), mental confusion, muscle hyperirritability,
incoordination
____________________ may be take for alcohol and/or benzodiazepine withdrawal
Anticonvulsants
What is taken to remove lithium from the body if toxic levels are reached?
Kayexalate
___________ are taken for aggressive behaviors r/t BPD, they have a calming effect
Anticonvulsants
What must the nurse monitor while a patient is taking an anticonvulsant?
LFTs/liver enzymes, platelet count
*causes liver probs., decreases platelets
Valproate (Depakote) is an _____________ that should not be taken at which age?
anticonvulsant; childbearing ages (can caise NTDs)
Valproate (Depakote) is an ____________ that can cause _________, __________, and
_______ failure
anticonvulsant; hair loss, pancreatitis, liver failure
Carbamazepine (Tegretol) is an ___________ that can cause __________, increases risk for
________, and has many drug _____________
anticonvulsant; anemia, infection/sepsis (destroys WBCs), drug interactions
Lamotrigine (Lamictal) is an ___________ that must be started on a _____ dose
anticonvulsant; low dose
Because Lamotrigine (Lamictal) can cause _________ _________ syndrome, patients must
report signs of ________
, Steven Johnson syndrome, rash
Second-Generation ____________ helps with _________ of BPD
antipsychotics, management
What antipsychotics helps with acute mania by calming the patient down, but it
causes severe weight gain?
Olanzapine (Zyprexa)
*second-gen.
Quetiapine (Seroquel, Seroquel XR) is an __________ used to treat __________
antipsychotic (second- gen.), depression
______________ has the same s/s as depression
Hypothyroidism
*must be ruled out first before diagnosed with major depressive disorder
Disruptive mood dysregulation disorder is most commonly seen in _________
kids
Symptoms of depression include:
Feelings of sadness/emptinesirratibiltiy, somatic/body concerns (HA, stomach ache), impaired
thinking
*all impact person's ability to function
Which disorder is characterized by low-level depressive feelings through most of each day,
for the majority of days
Persistent depressive disorder
*formerly known as dysthymia
Persistent depressive disorder lasts at least __ years in adults and ___ year in children and
adolescents
2 years, 1 year
Symptoms of persistent depressive disorder:
decreased appetite/overeating, insomnia/hypersomnia, low energy, poor self-esteem, difficulty
thinking, feelings of hopelessness
*^^milder symptoms of MDD; must have 2 or more to be diagnosed
When to check blood levels of Lithium?
8-12 hours after taking, every week, then every 3 months
How do OTC medications interfere with lithium?
Interfere w/ excretion of Li, increases Li levels in blood
_________ are OTC medications that interacts with Lithium
NSAIDs
When can a patient take a missed dose of Lithium?
Within 2 hours
Lithium must be taken at the same time each day. T/F?
TRUE
Patient will need to stay _________ when taking lithium due to the inverse relationship of
lithium and __________
hydrated; sodium (Na)
How long does it take for lithium to "kick in?"
1 week
__________ is taken for acute mania and depression, it treats current symptoms and
prevents future relapse
Lithium (Li)
Medications for BPD I include:
Lithium, anticonvulsants, second-gen. antipsychotics
Therapeutic range for Lithium:
0.6-1.2 mEq/L
What is the toxic blood level for litium?
1.5 mEq//L & above
Contraindications for Lithium:
Kidney probs., diuretic use (excretion of Na, retention of Li), pregnancy, cardiovascular disease
What must assessed before lithium is administered?
,Creatinine levels
*can cause kidney probs
Side effects of lithium include
Fine hand tremor, mild thirst, mild nausea, GI discomfort (take WITH meals), mental confusion,
renal toxicity (long-term), acne, hair loss, muscle weakness
Signs of lithium toxicity include:
Coarse hand tremors, persistent diarrhea (GI upset), mental confusion, muscle hyperirritability,
incoordination
____________________ may be take for alcohol and/or benzodiazepine withdrawal
Anticonvulsants
What is taken to remove lithium from the body if toxic levels are reached?
Kayexalate
___________ are taken for aggressive behaviors r/t BPD, they have a calming effect
Anticonvulsants
What must the nurse monitor while a patient is taking an anticonvulsant?
LFTs/liver enzymes, platelet count
*causes liver probs., decreases platelets
Valproate (Depakote) is an _____________ that should not be taken at which age?
anticonvulsant; childbearing ages (can caise NTDs)
Valproate (Depakote) is an ____________ that can cause _________, __________, and
_______ failure
anticonvulsant; hair loss, pancreatitis, liver failure
Carbamazepine (Tegretol) is an ___________ that can cause __________, increases risk for
________, and has many drug _____________
anticonvulsant; anemia, infection/sepsis (destroys WBCs), drug interactions
Lamotrigine (Lamictal) is an ___________ that must be started on a _____ dose
anticonvulsant; low dose
Because Lamotrigine (Lamictal) can cause _________ _________ syndrome, patients must
report signs of ________
, Steven Johnson syndrome, rash
Second-Generation ____________ helps with _________ of BPD
antipsychotics, management
What antipsychotics helps with acute mania by calming the patient down, but it
causes severe weight gain?
Olanzapine (Zyprexa)
*second-gen.
Quetiapine (Seroquel, Seroquel XR) is an __________ used to treat __________
antipsychotic (second- gen.), depression
______________ has the same s/s as depression
Hypothyroidism
*must be ruled out first before diagnosed with major depressive disorder
Disruptive mood dysregulation disorder is most commonly seen in _________
kids
Symptoms of depression include:
Feelings of sadness/emptinesirratibiltiy, somatic/body concerns (HA, stomach ache), impaired
thinking
*all impact person's ability to function
Which disorder is characterized by low-level depressive feelings through most of each day,
for the majority of days
Persistent depressive disorder
*formerly known as dysthymia
Persistent depressive disorder lasts at least __ years in adults and ___ year in children and
adolescents
2 years, 1 year
Symptoms of persistent depressive disorder:
decreased appetite/overeating, insomnia/hypersomnia, low energy, poor self-esteem, difficulty
thinking, feelings of hopelessness
*^^milder symptoms of MDD; must have 2 or more to be diagnosed
