Limictrine (lamotrigine) - Steven Johnsons syndrome
Depressive - sleeping more, anhedonia,
Suicide thoughts - access plan and intent to act
Fluoxetine “mood is so much better, I stopped taking it” - access suicide risk, monitor anxiety, vitals, notify doctor,
Oppositional defiant long-term goals - cbt and meds, create a safe environment, set consistent limits and expectations, follow through with consequences, activities.
Eye exam nystagmus (lateral orbital palsy), altered gait, confusion, sluggish = alcohol withdrawal - administer tyramine
Someone with anorexia struggles to gain weight, History of Purging - monitor bathroom use
Hypertension can decrease sex drive - ask about sexual health, don’t take viagra
Someone who is hostile - approach calmly
Someone detoxing thinks bugs are crawling on them, diaphoretic - give lorazepam
Agoraphobia - exposure therapy, NO medication for it
Factitious disorder - demands specific treatments, doesn’t interact with family, understands medical jargon
Someone in an abusive relationship who is afraid of what to ask - “Are there guns in the house?” “Have they ever hurt you?” “Do you have resources?”
Stop someone from drinking - Disulfiram
Manic phase in bipolar becomes vulgar - set boundaries and limits
Borderline personality priority interventions - monitor self-injurious behaviors, suicide risk
Conversion disorder - symptoms relieve anxiety, Neurologic issue (blind, deaf, can't move leg)
Somatic - Hypochondriac
Med for hopelessness, anxiety, - fluoxetine
Patient has low energy, hopelessness, sadness test - TSH: thyroid
Crossing professional boundaries - giving advice, sitting on their bed,
Phenelzine discharge teaching - no tyramine food, at least monthly blood pressure checks, monitor over-the-counter meds, and effects on sleeping habits
The patient curled up on a stretcher, feels like a heart attack, asking for meds - vitals
Reduce panic attacks - deep breathing, dim lights, stay with them, walk with them
Vagal nerve stimulation and ect - no memory loss in VNS
Major depressive disorder acute phase treatment - encourage nutrition intake, hygiene,
Autism disorder on fluoxetine: how to know it works - decrease anxiety, more interaction with peers
Methaphanate - weight loss, decreased appetite, increased BP
Pool ball - tell them to put it down
Patient asks why childhood events affect or cause schizophrenia - Triggers and Genetics
ACT team - for rural areas and home health-like needs, monthly medication, scheduling
MAOI Selegiline adverse effects - hypertensive crisis
Transference - patient to nurse countertransference - nurse to patient
Lithium toxicity (>1.5) - seizure precautions and fluids
Clozapine (2nd gen antipsychotic) - monitor WBC
Child having tantrum throwing themselves everywhere - restrain so they don’t hurt themselves
Amphetamine overdose = monitor BP
Neologism - Using made up words (THINKALATOR)
Command Hallucinations - Ask what they are hearing
Spouse asks when their schizophrenic partner will get better - as long as they manage their symptoms, they will have times when they get better
Conduct disorder - pulling on a dogs ear for fun
Child being disruptive - have a conversation and put them in a timeout in calm, quiet area
Patient is newly on lithium - teach them to maintain salt intake and fluids, and manage weight (may gain 5lbs in first week)
Started on Proxatine 48 hours ago, having bad symptoms (serotonin syndrome) - Stop med, cool patient (cause they will have a fever), give Propanerole
Acute dystonic reaction from Haldol - Head rotates to only 1 side, jaw thrust forward, stiff position
Schizophrenia (restlessness, can’t stop moving) - EPS
Pre ECT - NPO and hold meds and teach about possible short-term memory loss
Post ECT - monitor for memory loss, increased temp and pain levels
Discharge teaching for sertraline - weight gain, 2-4 weeks to reach therapeutic effect, and monitor for suicidal thoughts