Exam 2- Psych meds/disorders; General guidelines
The intention of this quizlet is to form a general "rule book" to guide thinking when navigating the wonderful world of psych meds/disorders. NOT comprehensive.. just a broad view
Terms in this set (68)
Drug classes that treat schizophrenia
Conventional (first gen) antipsychotics
Atypical (Second gen) antipsychotics
What do first generation meds target for schizophrenic
Universal precaution for antipsychotics
Drugs to give for LSD overdose to treat anxiety or tension?
diazepam/ chloral hydrate
Nursing interventions for LSD
Minimize stimuli, One to one care, speak with slow clear voice
main first gen. antipsychotics for SERIOUS schizophrenia
Lesser potent drug for less serious cases of schizophrenia
Acronyms to help with symptoms of antipsychotics
WTF is TAAP?
WTF is SLUDGE?`
Sedative, Lethargy, Energy Loss
Anticholinergic ( Urine retention, Dry mouth, GI upset)
ADVERSE reaction to 1st gen antipsychotics
Neuroleptic Malignant syndrome
Symptoms of neurloeptic malignant syndrome
Muscle rigidity, Altered level of consciousness
Interventions for neuroleptic malignant syndrome
Stop the med and cool the patient
PT. edu with first gen antipsychotics
Take with food if GI upset and dry mouth occurs
Nursing guidelines with antipsychotics
Monitor glucose and liver labs
What drugs are usually prescribed with antipsychotics to reduce Parkinsonian symptoms?
diphenhydramine hydrochloride (Benadryl) -9/10 times
benztropine mesylate (Cogentin)
trihexyphenidyl (Artane)- least often
What symptoms to 2nd gen antipsychotics treat?
Positive or negative
Why are 2nd usually preferred over 1st gen antipsychotics?
Less EPS symptoms, Less anticholinergic effects,
Main 2nd gen antipsychotics
Disadvantages of 2nd gen antipsychotics
WTF is metabolic syndrome?
Weight gain, altered glucose, dyslipidemia
Risk of diabetes, hypertension, atherosclerosis, and increase in heart diseases
WTF is dyslipidemia?
Abnormalities with one or more of the blood fats (lipids)
What other classes of drugs are added to antipsychotic drug therapy?term-58
Antidepressants, mood stabilizers, benzos
Intoxication of LSD symptoms
EVERYTHING GETS FAST
tachycardia, tremors, incoordination, elevated temp/pulse, anxidty/depression, Hearling colors, seeing sounds
PCP intoxication symptoms
increased BP, P, T
Ataxia, muscle rigidity seizures blank stare chronic jerking, impulsiveness (beligerent, assaultiveness)
SEVERE PCP affects
Violent/bizarre behavior (barking, chanting)
Treatment for PCP OD
ammonium choride acidifies urine to help excrete drug from bod(10-14 days)
Speak slowly and in low voice, rm with minimum stimuli
NEVER combine 2nd gen antipsychotics with.....
Levodopa is an anti parkinson's medication; will cancel each other out.
With 2nd gen. antipsychotics, what are some general precautions
Watch for glucose dysregulation
weighgain in pts.
Good pt. education with 2nd gen antipsychotics?
Watch for hypertension, increasesed risk for cardiovascular disease r/t increased cholesterol
Watch for signs of diabetes r/t glucose dysregulation
Beware of weight gain
Overall goal for pt. in the acute phase of schizophrenia
Safety and medical stabilization
So if a pt. has potential to hurt self or others, initial pt. outcomes should reflect that. Ex:
Pt. consistently refrains from hurting self or others
Pt. consistently refrains acting on delusions or halucinations
PHASE 2 Stabilization phase. What is the priority?
Continual recovery, improvement in functioning and enhancement of pt's quality of life
Pt: " I hear my mom's voice saying terrible things about me. She says she regrets that I was born and the world would be better without me."
Nurse: "That must be very upsetting, Tom. Are you feeling upset?" (Nurse waits for response)
WHY is this the right response by the nurse? (pg. 314)
Pt. "Yes, I feel bad."
Nurse: "Let's go over here and play poker. I hear you're a very good poker player."
The nurse started the conversation with acknowledging the feelings of the patient. In an attempt to distract the pt. the nurse encourages something that the patient can do well.
Ok. So that's the rationale. It threw me off initially cuz it's reminiscent of entering a pt's room who is crying and saying "It's a nice day, let's open the window." BUT, in the context of the conversation, it's beneficial to reinforce the good in the patient. So acknowledging his feelings but not entertaining them and bringing him back to reality by engaging him in something he is good at is the best route of action.
If a patient threatens himself of others, what is done and how is it documented?
Contact authorities/follow facility protocol.
Document who was contacted/notified and when.
WTF is a delusion?
A false belief or opinion, especially one held in spite of contradictory evidence
WTF is a hallucination?
False sensory experiences, such as seeing something in the absence of an external visual stimulus
In what ways does PCP mess up the body?
IV: HIV, AIDS, Hepatitis, Bacterial endocarditis, renal failure, cardiac arrest, coma, seizures, respiratory arrest, dermatitis, pulmonary emboli, tetanus, abscesses-- osteomyelitis, septicemia
Ingested: Respiratory Arrest
-Attempting to control someone else's drug use
-Covering up for the person's substance use
-Often bailing the addicted person out of financial or legal problems
Examples of overresponsible behaviors
Assessment modalities to assess for substance abuse
Hx of substance abuse
What's contained within psychiatric history?
Depression? Schizophrenia? etc
What's contained within psychosocial issues?
Poor work record
has substance abuse affected relationships
Three questions that are usually enough to reveal intimate partner violence:
1.Have you been hit, kicked, punched, or otherwise hurt by someone within the past year? If so, by whom?
2.Do you feel safe in your current relationship?
3.Is there a partner from a previous relationship who is making you feel unsafe now?
What if a woman is getting abused but doesn't want to press charges?
Give her references to local resources:
Hotlines, shelters, battered women's groups
Battered women's advocates
Aid to Families with Dependent Children (AFDC)
Chloe is now being seen by the ED physician. Her husband, Chad, is quietly demanding to see his wife. As the triage nurse, what are your best actions? Select all that apply.
A. Tell Chad that Chloe "is fine" but no room for visitors is provided.
B. Have staff members (e.g., physician, nurse, technician, assistant) make regular contact with Chad in the waiting room.
C. Immediately call hospital security.
D. Move Chloe to secluded area in the ED so that you can interview her in private.
E. Insist that Chloe admit she is being abused by Chad.
F. Immediately report the abuse to the police department.
G. Advise Chloe of SAFE SHELTERS, and offer brochures.
During a nursing assessment, which of the following is a " red flag" for suspecting that a patient has been a victim of physical violence?
1. Patient's explanation does not match the injury.
2. Patient has no history of stress- related physical problems.
3. Patient mentions having a concerned, supportive spouse.
4. Patient is anxious but open and direct in explaining the complaint or injury.
Reduces or eliminates alcohol craving
Helps patient abstain from alcohol
Works to decrease alcohol cravings
Alcohol-disulfiram reaction causes unpleasant physical effects.
Common signs of stimulant abuse
Dilation of the pupils
Dryness of the oronasal cavity
Excessive motor activity
Withdrawal symptoms include depression, paranoia, lethargy, anxiety, insomnia, nausea, vomiting, sweating, and chills.
Cocaine and crack
Is a synthetic opiate that blocks the craving for and effects of heroin.
Is an alternative to methadone.
Is an antagonist that blocks the euphoric effects of opioids.
Is an effective somatic treatment when combined with naltrexone.
Blocks the signs and symptoms of opioid withdrawal.
Common co-occcurences with personality disorders
Substance abuse, somatic symptom disorders, eating disorders, PTSD, depression, anxiet, general medical condiions
characteristic that define borderline personality disorder
Characteristics that define narcissistic PDs
Are the meds for personality disorders?
No man. Not specifically. BUT, there are meds used to treat the symptoms. You don't treat the borderline personality disorder, but you do treat the depression an/or anxiety associated with it.
Drug that targets impulsivity and self harm
Drugs that minimize aggression
Lithium, anticonvulsants, SSRIs
Drugs that help with psychotic features
Drugs that treat comorbid depression and panic attacks
Drugs that have low toxicity in overdose
Trazodone and venlafaxine
Withdrawal symptoms of ETOH, Benzodiazepines
N/V, tachycardia, diaphoresis, anxiety/irritability, TREMORS in hands fingers, eyelids
GRAND MAL seizures
Can abrupt ETOH/benzo withdrawal lead to death?
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