Psych Nursing (ATI) Flashcards

Terms Definitions
BuSpar is used to treat what?
It's contraindicated for use with what type of antidepressant?
What do you monitor?
- treats anxiety (non-Benzo)
- contraindicated with MAOI's
- monitor renal and liver fxn
what are benzodiazepines for?
anxiety disorders like:
OCD, panic, disorder, PTSD, phobias, alcohol w/drawal, and seizures
what category is Valium, Xanax, Librium, Ativan, and Klonopin?
what's the general side effect of benzodiazepines?
CNS depression, sedation, etc.
what's the first choice drug category for treating depression?
what are 3 other main categories of antidepressants?
- tricyclics
- MAOI's
- Atypicals
Name a few SSRI's:
how long's the lag period for antidepressants?
1-3 weeks for relief,
but can wait up to 2-3 months for desired outcomes
antidepressants can be used to treat bulimia or anorexia?
bulimia nervosa
4 major side effects of SSRI's:
- sexual dysfunction
- weight gain
- insomnia, anxiety, HA
- serotonin syndrome
5 S&S of serotonin syndrome:
- confusion, hallucinations
- agitation, anxiety
- hyperreflexia
- fever
- tremors
avoid what 2 substances when taking SSRI's?
- St. John's Wort
- MAOI's
6 cautions for pts considering SSRI's:
- pregnancy
- lactation
- renal probs
- liver probs
- cardiac diseases
- seizures
advise older clients on SSRI's to monitor what?
sodium levels
how to take SSRI's?
with meals
Tofranil, Elavil, Aventyl, and Sinequan belong to what class?
Tricyclic antidepressants
main side effects of Tricyclic antidepressants:
- ortho hypotension
- anticholinergic effects
(blurry vision, dry mouth, constipation, tachycardia, photophobia, urinary retention)
- cardiac toxicity
- sedation
how to take tricyclic antidepressants?
at bedtime
what drug class is Nardil and Marplan?
MAOI's (antidepressants)
3 side effects of MAOIs:
- CNS stimulation
- ortho hypotension
- hypertensive crisis
what foods to avoid when taking MAOIs:
- figs, avacados, bananas
- beer and wine
- cheeses
- caffeine and chocolate
- liver, smoked, fermented meat
- dried or cured fish
- OTC decongestant meds
what drug class if Wellbutrin, Effexor, and Remeron?
Atypical antidepressants
side effects of atypical antidepressants:
- dry mouth, constipation, increased HR
- nausea & weight loss
- headache
- restlessness, seizures
what is Lithium and Depakote used to treat:
side effects of Lithium:
- FINE tremors
- polyuria
- confusion
- headache
- fatigue
- weight gain
- nausea, diarrhea, & abd pain
5 major S&S of Lithium toxicity:
- COARSE tremors
- slurred speech, confusion
- muscle weakness, incoordination
- EKG changes
- persistent GI upset
what diet/drug changes are needed for a pt on Lithium therapy?
- lower calories
- take 2-3 L fluids per day
- avoid drugs with anticholinergic effects
4 main side effects of Depakote (valproic acid):
- GI effects
- hepatotoxicity
- pancreatitis
- thrombocytopenia
2 main uses of Lamictal:
- long term treatment for BIPOLAR I disorder
- epilepsy
3 main uses of Tegretol:
- epilepsy
- neuralgia (trigeminal)
- bipolar disorder
how often do you monitor lithium levels?
every 2-3 days in the beginning, then every 1-3 months
What's the therapeutic Lithium range?
What is a toxic lithium level?
0.4-1.3 mEq/L (THERAPEUTIC)
>1.5 mEq/L (TOXIC)
2 major effects of ECT:
- confusion
- memory loss
4 indications for ECT:
- acute mania
- actively suicidal pts
- depression and schizo that is nonresponsive to meds
4 contraindications for ECT:
- MI
- intracranial mass
- cerebrovascular malformation
how is ECT prescribed?
3 times a week,
6-12 treatments total
what meds are to be discontinued 2 weeks prior to ECT?
MAOI's and Lithium
what's neologism?
a made up word
what's echolalia?
client repeated the words spoken to him
what's clang association?
meaningless rhyming of words
what's thought broadcasting?
belief that one's thoughts are heard by others
what's thought insertion?
belief that others' thoughts can be inserted into one's brain
is disorganized speech a positive or negative symptom of schizo?
what's avolition, alogia, anhedonia, and anergia?
Negative symptoms of schizo:
- avolition = lack of desire
- alogia = lack of speech
- anhedonia = inability to experience pleasure
- anergia = lack of energy
what's agnosia?
difficulty recognizing things
what's apraxia?
inability to perform familiar acitivites
what's aphasia?
difficulty finding the right word
cocaine use in the 2nd and 3rd trimesters commonly lead to which 2 problems?
- preterm labor (usu. SGA infant)
- placenta abruptio
traits of infants exposed to cocaine in utero:
- high pitched cry and tremors
- irritability
- poor feeding
- high HR and RR
- small head
- low birth weight
- lack of response to face/voice
T/F. Dementia often worsens in the morning right after awakening.
Dementia often worsens at night.
what characterizes early phase of dementia?
- impairment of thinking, judgement, and impulse control
- negligence of hygiene and appearance
- personality changes
name two alzheimer meds:
- aricept (donepezil)
- exelon (rivastigmine)
- cognex (tacrine)
pts with severe anxiety have a narrowed or widened perceptive field?
T/F. Pts with moderate/mild levels of anxiety are able to ID and describe feelings of anxiety, the causes, and adaptive ways to cope.
they can think more clearly than a pts with severe anxiety
4 symptoms of psychoses:
- delusions
- hallucinations
- disorganized thought
- disorganized behavior
T/F. PRN restraint orders should be made for violent pts.
PRN restraint orders should NEVER be made for anyone.
in assessing for risk of violence, the most important predictor is?
past history
T/F. Do not tell a pt with eating disorder his or her actual weight when you weigh them daily.
T/F. Being of female gender is a risk factor for depression.
antianxiety meds are used for short or long term treatment?
short term.
in order to avoid dependence.
2 basic categories of antianxiety meds are:
- benzodiazepines
- non-benzodiazepines
the absorption of benzodiazepines is slowed by what?
- antacids
- food in stomach
what potentiates the effects of benzodiazepines and should be avoided?
- alcohol
- other CNS depressants
Buspar is not associated with which 3 side effects that is associated with benzodiazepines?
- sedation
- cognitive impairment
- withdrawal symptoms
atypical antipsychotics treat the negative or positive symptoms of schizo?
negative symptoms
side effects of atypical antipsychotics:
- sedation
- weight gain
- minimal anticholinergic effects
pts taking clozapine (clozaril) should have what monitored every 1-2 weeks and why?
watch for decreasing WBC count (agranulocytosis)
traditional antipsychotics have a higher incidence of what?
EPS (extrapyramidal symptoms)
4 EPS symptoms:
- dystonia
- akathesia
- parkinsonism
- tardive dyskinesia
side effects of traditional antipsychotics:
- anticholinergic symptoms
- ortho hypotension
- reduction of seizure thresthold
what can decrease blood concentrations of traditional antipsychotics?
what common OTC can treat the EPS acute dystonia?
what is dystonia?
spasm of the tongue, throat, jaw, face, eyes, neck, and upper body
what is akathesia?
inner and outer restlessness, inability to remain still
what's pseudoparkinsonism?
tremors, hypersalivation, cogwheel rigidity, shuffling gait, stooped posture
what's tardive dyskinesia?
late-occurring involuntary repetitious movements of muscles of face, limb, and trunk
pts who are taking pscyhotropic meds are screened how often for tardive dyskinesia?
every 6 months
what type of antidepressants cannot cause a lethal overdose?
what kind of pts cannot take tricyclic antidepressants and why?
suicidal pts,
because of the risk of cardiac toxicity in case of overdose
4 S&S of hypertensive crisis:
- headache, lightheadedness
- heavy sweating
- vomiting
- increased HR
give what other meds until mood stabilizing meds become affective?
Lithium should be contraindicated for what 2 types of pts and should be used with caution for which 2 types of pts?
Contraindication: renal & cardiac pts

Caution: diabetics & thyroid pts
how should you take lithium? (before, during, or after meals?)
with food
4 common symptoms of psychostimulants (e.g. for ADHD):
- weight loss
- insomnia
- headache
- tachycardia
how should you take psychostimulants?
- after meals
- at least 6 hours before bedtime
2 types of sedative-hypnotics:
(hint: same as antianxiety meds)
- benzo
- non-benzo
what characterizes stage IV of alzheimers?
there is no stage IV
what herbal med for depression is widely used in Europe?
St. John's wort
(serotonin-elevating properties)
what is gingko-biloba used for?
enhances mental acuity
What refers to the mistaken belief that neutral stimuli have special meaning?
ideas of reference
What should the nurse include in her teaching about phenytoin (Dilantin)?
- monitor for skin rash
- practice good oral hygiene because Dilantin can cause gingival hyperplasia
- regular blood works needed to monitor plt lvl, liver fxn, drug lvls
- toxicity S&S including lethargy, balance disturbance, nystagmus, slurred speech
- do not take if pregnant (birth defects)
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