ADVANCED PATHOPHYSIOLOGY NURS 6501 FINAL EXAM PREP
QUESTIONS AND CORRECT ANSWERS/ NURS 6501 FINAL EXAM WEEK
11
What labs would be appropriate to draw if you initiate fluoxetine in a geriatric patient? - CORRECT
ANSWERS-Sodium levels
- Baseline screening & after 3-4 weeks in high-risk patients (> 65yrs, previous hx of antidepressant-
induced hyponatremia, low body weight, concomitant use of thiazides or other hyponatremia-inducing
agents)
- monitor regularly in the elderly
What are potential side effects of SSRI medications?
- what are the common SSRIs, LEAP of them, and zoloft AE - CORRECT ANSWERS-Common
SSRIs:
Lexapro, celexa, paxil, zoloft, prozac
L = decreased libido and sleep
E = Neutral effect on energy
A = neural effect on addiction
P = celexa may stop working after awhile (increase or switch)
Zoloft AE:
Insomnia, somnolence, fatigue, abnormal ejaculation, suicidal thoughts
What are characteristics of major depressive disorder or MDD? 9 - CORRECT ANSWERS-
Diagnostics need 5 or more of the following:
- SS occur more days than not in a 2 week period
- SS cause significant impairment in any realm of functioning
- Depressed mood
- Loss of interest
,- Significant unintended ▲ in weight or appetite
- Significant ▲ sleep
- ▲ psychomotor activity (restlessness)
- Fatigue, loss of energy
- Worthlessness, guilt
What is serotonin syndrome? - CORRECT ANSWERS-- Increased serotonergic activity in the
CNS
- Can be due to therapeutic med use, inadvertent drug interactions, or self-OD
Serotonin in the Body:
CNS: Modulates attention, behavior, and thermoregulation
PNS: Regulates GI motility, vasoconstriction, uterine contraction, and bronchoconstriction, promotes PLT
aggregation
PE of serotonin syndrome 11 - CORRECT ANSWERS-- Hyperthermia, flushed skin, diaphoresis
- Agitation
- Slow, continuous, horizontal eye movements (ocular clonus)
- Dilated pupils
- Tremor, akathisia
- Deep tendon hyperreflexia (common)
- Inducible or spontaneous muscle clonus (common)
- Muscle rigidity
- Bilateral babinski
- Dry mucus membranes
- Increased bowel sounds
What is discontinuation syndrome (from SSRIs)?
"FINISH" - CORRECT ANSWERS-2-3 days after stopping SSRIs abruptly
, F: flu-like SS
I: insomnia
N: nausea
I: imbalance
S: sensory disturbances
H: hyperarousal
Bupropion
- MOA
- BENFITS
AE
CONTRA - CORRECT ANSWERS-MOA
- act to inhibit reuptake of NE, dopamine, and serotonin
BENFIT
- Depression
- Smoking cessation
- Seasonal affective disorder
- Treat sexual dysfunction relative to SSRI therapy
AE
- weight loss
- increases libido ⇒ combine with SSRI
- can cause seizures by lowering the seizure threshold
CONTRA
- History of seizures
- Do not prescribe to pts with psych disorders ⇒ ↑ risk for delusions or hallucinations
QUESTIONS AND CORRECT ANSWERS/ NURS 6501 FINAL EXAM WEEK
11
What labs would be appropriate to draw if you initiate fluoxetine in a geriatric patient? - CORRECT
ANSWERS-Sodium levels
- Baseline screening & after 3-4 weeks in high-risk patients (> 65yrs, previous hx of antidepressant-
induced hyponatremia, low body weight, concomitant use of thiazides or other hyponatremia-inducing
agents)
- monitor regularly in the elderly
What are potential side effects of SSRI medications?
- what are the common SSRIs, LEAP of them, and zoloft AE - CORRECT ANSWERS-Common
SSRIs:
Lexapro, celexa, paxil, zoloft, prozac
L = decreased libido and sleep
E = Neutral effect on energy
A = neural effect on addiction
P = celexa may stop working after awhile (increase or switch)
Zoloft AE:
Insomnia, somnolence, fatigue, abnormal ejaculation, suicidal thoughts
What are characteristics of major depressive disorder or MDD? 9 - CORRECT ANSWERS-
Diagnostics need 5 or more of the following:
- SS occur more days than not in a 2 week period
- SS cause significant impairment in any realm of functioning
- Depressed mood
- Loss of interest
,- Significant unintended ▲ in weight or appetite
- Significant ▲ sleep
- ▲ psychomotor activity (restlessness)
- Fatigue, loss of energy
- Worthlessness, guilt
What is serotonin syndrome? - CORRECT ANSWERS-- Increased serotonergic activity in the
CNS
- Can be due to therapeutic med use, inadvertent drug interactions, or self-OD
Serotonin in the Body:
CNS: Modulates attention, behavior, and thermoregulation
PNS: Regulates GI motility, vasoconstriction, uterine contraction, and bronchoconstriction, promotes PLT
aggregation
PE of serotonin syndrome 11 - CORRECT ANSWERS-- Hyperthermia, flushed skin, diaphoresis
- Agitation
- Slow, continuous, horizontal eye movements (ocular clonus)
- Dilated pupils
- Tremor, akathisia
- Deep tendon hyperreflexia (common)
- Inducible or spontaneous muscle clonus (common)
- Muscle rigidity
- Bilateral babinski
- Dry mucus membranes
- Increased bowel sounds
What is discontinuation syndrome (from SSRIs)?
"FINISH" - CORRECT ANSWERS-2-3 days after stopping SSRIs abruptly
, F: flu-like SS
I: insomnia
N: nausea
I: imbalance
S: sensory disturbances
H: hyperarousal
Bupropion
- MOA
- BENFITS
AE
CONTRA - CORRECT ANSWERS-MOA
- act to inhibit reuptake of NE, dopamine, and serotonin
BENFIT
- Depression
- Smoking cessation
- Seasonal affective disorder
- Treat sexual dysfunction relative to SSRI therapy
AE
- weight loss
- increases libido ⇒ combine with SSRI
- can cause seizures by lowering the seizure threshold
CONTRA
- History of seizures
- Do not prescribe to pts with psych disorders ⇒ ↑ risk for delusions or hallucinations
