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Mental Health - Exam 1
Terms in this set (50)
A hospitalized client is taking clozapine for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client should the nurse specifically review to monitor for an adverse effect associated with the use of this medication?
White blood cell count
Disulfiram is prescribed for a client and the nurse is collecting data on the client and is reinforcing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication?
When the last alcoholic drink was consumed
The nurse is collecting data from a client, and the client's spouse reports that the client is taking donepezil hydrochloride. Which disorder should the nurse suspect that this client may have based on the use of this medication?
Fluoxetine is prescribed, and the nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about the administration of this medication?
"I should take the medication in the morning when I first arise."
A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan?
Arrives at the clinic neat and appropriate in appearance
A hospitalized client is prescribed phenelzine sulfate for the treatment of depression. The nurse reinforces instructions to the client and tells the client to avoid consuming which foods while taking this medication?
- Aged cheese
A client taking buspirone for 1 month returns to the clinic for a follow-up visit. Which should indicate medication effectiveness?
No rapid heartbeats or anxiety
A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is checked as a part of the routine follow-up, and the level is 3.0 mEq/L (3.0 mmol/L). The nurse knows that this is which level?
A client arrives at the health care clinic and tells the nurse that they have been doubling their daily dosage of bupropion hydrochloride to help them get better faster. The nurse understands that the client is now at risk for which problem?
The nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine. Which information should be important for the nurse to gather regarding the adverse effects related to the medication?
What reactions can occur when taking Clozapine?
Hematological such as agranulocytosis and mild leukopenia
Disulfiram is contraindicated with which medical conditions?
Severe heart disease, psychosis, or hypersensitivity
Donepezil hydrochloride (a cholinergic agent) is prescribed to treat which disease?
Mild to moderate dementia of the Alzheimer's type
What foods should be avoided when taking a monoamine oxidase inhibitor (MAOI)?
Foods high in Tyramine (yogurt, aged cheeses, smoked or processed meats, red wines, and fruits such as avocados, raisins, and figs)
What is Buspirone hydrochloride most often used for?
The treatment of anxiety and depression
What is the therapeutic serum level of lithium?
0.8 to 1.2 mEq/L
What lithium serum level indicates toxicity?
What category of medication is Bupropion?
An atypical antidepressant
What are side effects of Bupropion?
Weight loss and insomnia; seizure activity in dosages greater than 450mg daily
What are the most common adverse effects of Fluoxetine?
- GI (nausea, vomiting, cramping, diarrhea)
Which response should the nurse make to a patient who states "I am really concerned about my mom"
- " Tell me what is troubling you"
- " Tell me about what you are feeling right now"
- " It seems you feel responsible for what happened to your mother"
What response should the nurse make to a client who has cancer, is scheduled to receive chemotherapy, and wants to try homeopathic treatments first?
"Tell me more about your concerns about taking chemotherapy"
What therapeutic statement should the nurse make to a parent who recently lost, states she cries frequently and can't bear the loss?
"You are feeling great pain at the loss of your child"
What is an example of a therapeutic statement when assessing schizophrenic patient?
"What activities did you enjoy in the past"
What is the therapeutic response time for Fluoxetine (Prozac), an SSRI?
1 - 3 weeks and full therapeutic effects may take 2 to 3 months
What information should be reinforced for a pt taking Lithium?
Thyroid function tests must be performed every 6mo due to the possibility of hypothyroidism
What is valproate used for?
A mood stabilizer for bipolar disorders
What information should be reinforced to a pt taking valproate (Depakote)?
Liver function tests must be done regularly due to possible hepatotoxicity which is a rare but serious adverse effect
Which are characteristics of Tardive Dyskinesia?
Chronic involuntary muscular contractions
What are characteristics of Neuroleptic malignant syndrome?
Muscle rigidity, hyperpyrexia, diaphoresis
What are characteristics of Acute dystonia?
Acute muscle contractions of the head and neck
What are characteristics of pseudoparkinsonism?
Tremors and impaired gait
What are safety risks for a pt receiving treatment for alcohol detoxification (withdrawals)?
Vitamin deficiency, Diaphoresis, Increased heart rate, ILlUSIONS
What findings are expected from a pt who is taking chlorpromazine (Thorazine) and displaying signs of extrapyramidal side effects?
muscle contractions of the neck, fidgeting behavior, impaired gait
What is St. John's wort primarily used for?
To treat mild to moderate depression and to relieve depression-related anxiety
What is Echinacea primarily used for?
To stimulate the immune system
What is Ginkgo biloba primarily used for?
To enhance cognitive functions and improve memory
What is Ginseng primarily used for?
To improve overall energy and vitality, particularly during times of fatigue or stress (boosts vitality and libido)
What should be included when performing a mental status examination?
Appearance, behavior, speech, mood, disorders of the form of thought, perceptual disturbances, cognition, and ideas of harming self or others
What is Alprazolam?
A benzodiazepine (psychoactive drug) that works in the CNS to decrease the severity of panic attacks, decrease anxiety and insomnia, and promote relaxation of muscles
What are physical manifestations of anxiety as it reaches the panic level?
Tension, impatience, apprehension, increased heart and respiratory rates, confusion, feelings of impending doom, and extreme fright and horror
What are adverse effects of Alprazolam?
Dizziness, lightheadedness, and drowsiness
What are manifestation of alcohol withdrawal delirium?
Severe disorientation, psychotics effects (hallucinations), severe hypotension, and cardiac dysrhythmias. (Considered a medical emergency and can progress to death)
What are common manifestations of Opiod withdrawal?
Agitation, INSOMNIA, FLU-LIKE MANIFESTATIONS, RHINORRHEA, YAWNING, sweating, nausea or vomiting, PUPILLARY DILATION, DIARRHEA
Which medication can be used for abstinence maintenance following alcohol withdrawal?
What are the intended effects of Disulfiram when used with even small amounts of alcohol?
Acetaldehyde syndrome (nausea, vomiting, weakness, sweating, palpitations, and hypotension which can lead to respiratory depression, cardiovascular suppression, seizures and death)
What medications are used to control aggressive and impulsive behaviors?
O Lanza pine and ziprasidone (atypical antipsychotics)
What medication can be used to control aggressive and impulsive behavior?
What nursing actions need to be implemented with a pt taking Haloperidol?
Monitor for clinical findings of Parkinsonian and anticholinergic adverse effects; keep client hydrated, check vital signs, and test for muscle rigidity due to the risk of neuroleptic malignant syndrome
What is Duloxetine used for?
An SNRI used to treat Depression, generalized anxiety disorder, neuropathy, and fibromyalgia
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