Exam 4: NURS 663/ NURS663 (Latest 2024/ 2025
Update) Psychiatric Mental Health Diagnosis and
Management II Complete Guide | Qs & As| 100%
Correct| Grade A (Verified Answers)- Maryville
what are modifiable risk factors for suicide? - ANSWER- unrealistic expectations
perfectionism
poor coping skills
what are some warnings signs of suicide? - ANSWERideation, substance use
purposelessness, anxiety, "trapped", hopeless
withdrawal, anger, recklessness, mood changes
what three classes of medication are used as mood stabilizers? - ANSWERlithium
anticonvulsants
antipsychotics
what medication can help reduce the risk of suicide? - ANSWERlithium
what symptoms of bipolar does lithium help? - ANSWERmania and depression
what blood tests need to be completed before starting lithium? - ANSWERkidney
(creatinine), TSH, CBC, pregnancy test
what is the goal blood trough level for lithium? - ANSWER0.6 - 1.2 mEq/L
what are the most common side effects of lithium use? - ANSWERGI upset
weight gain
tremor
hair loss/acne
can cause:
leukocytosis
polyuria/polydipsia secondary to ADH antagonism
thyroid abnormalities
what are the levels and signs of lithium toxicity? - ANSWERmild (1.5-2): lethargy,
tremor, increased GI upset
moderate (2-2.5) confusion, nystagmus
severe (>2.5) convulsions, oliguria, renal failure, seizures
what type of change on ECG might you see with lithium overdose? - ANSWERT wave
flattened
, what birth defect might be present with lithium use? - ANSWERebstein's anomoly
how do you treat lithium overdose? - ANSWER*dialysis*
sodium polystyrene sulfonate
what type of bipolar symptoms does valproic acid help? - ANSWERmania
- less effective with depression
what is the starting dose of lithium? - ANSWER300mg BID or TID
what types of bipolar patients might benefit most from valproic acid? -
ANSWERrapid cycling
mixed
patient with comorbid anxiety
comorbid substance use
what lab tests should be monitored with valproic acid? - ANSWERLFT, CBC,
pregnancy test
what supplement should be started in women of childbearing age who are taking
valproic acid? - ANSWERfolic acid
what is the target blood level of valproic acid? - ANSWER50-100 mcg/ml
what are side effects of valproic acid? - ANSWERthrombocytopenia, pancreatitis,
weight gain, hair loss, GI distress, cognitive dulling, neural tube defects in pregnancy
*weight gain and sedation
- watch for increase in ammonia and transaminitis
what two organs can be impacted by valproic acid? - ANSWERliver, pancreas
what birth defects might be observed with valproic acid? - ANSWERneural tube
defects, cleft palate
what is the first line treatment for acute mania and mania prophylaxis? -
ANSWERcarbamazepine
what type of bipolar symptoms is carbamazepine best for? - ANSWERmania (rapid,
mixed)
what lab tests should be checked with carbamazepine? - ANSWERliver, CBC, ekg
why is it important to check carbamazepine level at 1 month? - ANSWERit can induce
its own metabolism
Update) Psychiatric Mental Health Diagnosis and
Management II Complete Guide | Qs & As| 100%
Correct| Grade A (Verified Answers)- Maryville
what are modifiable risk factors for suicide? - ANSWER- unrealistic expectations
perfectionism
poor coping skills
what are some warnings signs of suicide? - ANSWERideation, substance use
purposelessness, anxiety, "trapped", hopeless
withdrawal, anger, recklessness, mood changes
what three classes of medication are used as mood stabilizers? - ANSWERlithium
anticonvulsants
antipsychotics
what medication can help reduce the risk of suicide? - ANSWERlithium
what symptoms of bipolar does lithium help? - ANSWERmania and depression
what blood tests need to be completed before starting lithium? - ANSWERkidney
(creatinine), TSH, CBC, pregnancy test
what is the goal blood trough level for lithium? - ANSWER0.6 - 1.2 mEq/L
what are the most common side effects of lithium use? - ANSWERGI upset
weight gain
tremor
hair loss/acne
can cause:
leukocytosis
polyuria/polydipsia secondary to ADH antagonism
thyroid abnormalities
what are the levels and signs of lithium toxicity? - ANSWERmild (1.5-2): lethargy,
tremor, increased GI upset
moderate (2-2.5) confusion, nystagmus
severe (>2.5) convulsions, oliguria, renal failure, seizures
what type of change on ECG might you see with lithium overdose? - ANSWERT wave
flattened
, what birth defect might be present with lithium use? - ANSWERebstein's anomoly
how do you treat lithium overdose? - ANSWER*dialysis*
sodium polystyrene sulfonate
what type of bipolar symptoms does valproic acid help? - ANSWERmania
- less effective with depression
what is the starting dose of lithium? - ANSWER300mg BID or TID
what types of bipolar patients might benefit most from valproic acid? -
ANSWERrapid cycling
mixed
patient with comorbid anxiety
comorbid substance use
what lab tests should be monitored with valproic acid? - ANSWERLFT, CBC,
pregnancy test
what supplement should be started in women of childbearing age who are taking
valproic acid? - ANSWERfolic acid
what is the target blood level of valproic acid? - ANSWER50-100 mcg/ml
what are side effects of valproic acid? - ANSWERthrombocytopenia, pancreatitis,
weight gain, hair loss, GI distress, cognitive dulling, neural tube defects in pregnancy
*weight gain and sedation
- watch for increase in ammonia and transaminitis
what two organs can be impacted by valproic acid? - ANSWERliver, pancreas
what birth defects might be observed with valproic acid? - ANSWERneural tube
defects, cleft palate
what is the first line treatment for acute mania and mania prophylaxis? -
ANSWERcarbamazepine
what type of bipolar symptoms is carbamazepine best for? - ANSWERmania (rapid,
mixed)
what lab tests should be checked with carbamazepine? - ANSWERliver, CBC, ekg
why is it important to check carbamazepine level at 1 month? - ANSWERit can induce
its own metabolism
