3/29/25, 8:02 Chapter 75, "Psychosocial Problems in Acute Care" NRNP 6550 |
AM
CHAPTER 75, "PSYCHOSOCIAL PROBLEMS IN ACUTE CARE" NRNP 6550 EXAM
QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Lorazepam 2mg; 1mg > 65
Haloperidol (Haldol) 5mg; 2 mg if age >65
Medications to treat agitation in an Olanzapine (Zyprexa): 10mg IM, oral 5mg
assaultive person Risperidone 2mg PO, rapid dissolving
BLACK BOX WARNING: when administering antipsychotics to the elderly for
dementia-related psychosis, there is an increase in mortality
- Diminished interest in normal activity, fatigue, lack of motivation feelings of
worthlessness, and impaired concentration nearly every day.
Subjective findings
- Hopelessness, helplessness, guilt, worthlessness, increased/decreased
Depression appetite, decreased libido
Labs to order
- TSH, CBC (r/o anemia or infection), Vitamin B12 and folate, drug screen, egg prior to
starting antidepressants
- Have you ever thought about death or dying?
- Have you ever thought that life was not worth living?
Questions to ask in a nonjudgemental - Have you ever thought about ending your life?
manner to assess suicide risk - Have you ever attempted suicide?
-Are you currently thinking about ending your life?
- what are reasons you want to live? or wanting to die?
- Serotonin toxicity r/t medications. Potentially life threatening associated with
increased serotonergic activity in the CNS.
- Described as a triad of mental status changes, autonomic hyperactivity,
and neuromuscular abnormalities,
What is Serotonin syndrome? (adverse S/S:
effect of antipsychotics) · Mental status change = anxiety, restlessness, disorientation, and agitated delirium
· Autonomic manifestations = dilated pupils, diaphoresis, tachycardia, hyperthermia,
hypertension, vomiting, and diarrhea
· Neuromuscular hyperactivity = tremors, myoclonus, hyperreflexia, and bilateral
Babinski signs, rigidity in lower extremities, seizures
end in [pram], [ine]
citalopram [Celexa];
SSRIs (selective serotonin reuptake
escitalopram [Lexapro];
inhibitors)
fluoxetine [Prozac];
paroxetine [Paxil]
sertraline [Zoloft];
Headache, drowsiness, dizziness, insomnia, anxiety, tremor, agitation, dry mouth,
anorexia, sexual dysfunction, SJS, serotonin syndrome, nausea
SSRIs adverse effects
- Well tolerated but many drug-drug interactions
1/
4
AM
CHAPTER 75, "PSYCHOSOCIAL PROBLEMS IN ACUTE CARE" NRNP 6550 EXAM
QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Lorazepam 2mg; 1mg > 65
Haloperidol (Haldol) 5mg; 2 mg if age >65
Medications to treat agitation in an Olanzapine (Zyprexa): 10mg IM, oral 5mg
assaultive person Risperidone 2mg PO, rapid dissolving
BLACK BOX WARNING: when administering antipsychotics to the elderly for
dementia-related psychosis, there is an increase in mortality
- Diminished interest in normal activity, fatigue, lack of motivation feelings of
worthlessness, and impaired concentration nearly every day.
Subjective findings
- Hopelessness, helplessness, guilt, worthlessness, increased/decreased
Depression appetite, decreased libido
Labs to order
- TSH, CBC (r/o anemia or infection), Vitamin B12 and folate, drug screen, egg prior to
starting antidepressants
- Have you ever thought about death or dying?
- Have you ever thought that life was not worth living?
Questions to ask in a nonjudgemental - Have you ever thought about ending your life?
manner to assess suicide risk - Have you ever attempted suicide?
-Are you currently thinking about ending your life?
- what are reasons you want to live? or wanting to die?
- Serotonin toxicity r/t medications. Potentially life threatening associated with
increased serotonergic activity in the CNS.
- Described as a triad of mental status changes, autonomic hyperactivity,
and neuromuscular abnormalities,
What is Serotonin syndrome? (adverse S/S:
effect of antipsychotics) · Mental status change = anxiety, restlessness, disorientation, and agitated delirium
· Autonomic manifestations = dilated pupils, diaphoresis, tachycardia, hyperthermia,
hypertension, vomiting, and diarrhea
· Neuromuscular hyperactivity = tremors, myoclonus, hyperreflexia, and bilateral
Babinski signs, rigidity in lower extremities, seizures
end in [pram], [ine]
citalopram [Celexa];
SSRIs (selective serotonin reuptake
escitalopram [Lexapro];
inhibitors)
fluoxetine [Prozac];
paroxetine [Paxil]
sertraline [Zoloft];
Headache, drowsiness, dizziness, insomnia, anxiety, tremor, agitation, dry mouth,
anorexia, sexual dysfunction, SJS, serotonin syndrome, nausea
SSRIs adverse effects
- Well tolerated but many drug-drug interactions
1/
4
