Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answ, Exams of Nursing

Download Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answ and more Exams Nursing in PDF only on Docsity! Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ What disorder goes hand in hand with mood disorders? - CORRECT ANSWERS ANXIETY Comorbidities: *substance abuse *schizophrenia *eating disorders Medical diagnoses often concurring with depression - CORRECT ANSWERS *diabetes *cancer *stroke *epilepsy *cardiac disease Serotonin Syndrome - CORRECT ANSWERS -caused by excess intra-synaptic serotonin - occurs from combining serotonin enhancing drugs -occurs from administering SSRIs too close to the discontinuation of MAOIs Serotonin Syndrome Symptoms - CORRECT ANSWERS -mania -ataxia, myoclonus (muscle twitiching) -nausea -Diarrhea -Tremors -headache, confusion -diaphoresis -restlessness -hyper-reflexia (over responsive reflexes) Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Serotonin syndrome treatment - CORRECT ANSWERS discontinue all serotonin medication and provide symptomatic support Electroconvulsive Therapy (ECT) - CORRECT ANSWERS - grand mal seizure caused by electrical currents via electrodes applied to temples -unilateral application for fever cognitive SE -bilateral application for severally ill Indications for ECT - CORRECT ANSWERS -postpartum psychosis -need for rapid response -severe Major Depression (90%) -prior positive responses to ECT -depression with psychotic features - failure of meds and/or psychotherapy -Bi-polar disorder unresponsive to medication -Schizophrenia with catatonic or affective symptoms Preparing pts for ECT - CORRECT ANSWERS -void -remove prostheses -no NPO 6-8 hrs prior to treatment -Pretreatment lab tests Pre ECT Medications - CORRECT ANSWERS -Iv injection of anesthetic (brevital sodium) -IV injection of muscle relaxant (succinylocholine-anctine 25-75 mg) Risk of Suicide - CORRECT ANSWERS -prior episodes of depression -family history of depression -prior suicide attempts -female gender Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Higher risk pts - CORRECT ANSWERS -transgender - 15- 24-year-olds Etiology of Depressive Disorders - CORRECT ANSWERS -substance abuse -medial illness -genetics -Biochemical Influences: decrease 5HT serotonin (influences mood, appetite, irritability, sleep/wakefulness) levels and norepinephrine -Hormonal: increased cortisol levels and elevated corticotrophin-releasing levels. -Inflammation -Cognitive theory:negative self-evaluation 4 hallmarks of major depression - CORRECT ANSWERS *Depressed mood lasting for minimum of 2 weeks* 1. depressed mood 2. anhedonia- loss of interest or pressure in things you normally like (may be most impt. landmark) 3. physical symptoms- sleep disturbance, appetite or weight change, low energy or fatigue, retardation or agitation. 4. 3 physiological symptoms- low self-esteem or guilt, poor concentration, suicidal ideation or persistent thoughts of death Nursing Diagnoses for Major Depression - CORRECT ANSWERS -risk for suicide -hopelessness -ineffective coping -spiritual distress - chronic low-self esteem -powerlessness Primary Care - CORRECT ANSWERS Actions taken to prevent illness or prevent the natural course of illness ex. mental health education Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Secondary prevention - CORRECT ANSWERS Interventions designed to promote early diagnosis of symptoms or timely treatment after onset of the disease Ex. depression screens Tertiary prevention - CORRECT ANSWERS Rehabilitation strategies designed to minimize handicapping effects of a disease. PREVENTS FROM TAKING YOU TOO FAR DOWN ex. teach pt about medication compliance TCAs - CORRECT ANSWERS MOA: inhibits reuptake of serotonin, norepinephirne & dopamine at the presynaptic neuron, allowing more serotonin to be available TCAs Pros and Cons - CORRECT ANSWERS -less expensive -as effective as new agents -SE are more problematic -start w/ low dose and titrate up -take 3-6 weeks to work TCA Cautions - CORRECT ANSWERS -take extreme cautions w/ suicidal pts -lethal dose is just 3-5 times the dose -dose greater than 1g is toxic and can be fatal -death results from cardiac arrythmias, hypotension, CNS suppression and seizures. SSRIs - CORRECT ANSWERS -suicidal thoughts may increase -fewer side effects -better pt adherence -best safety profile, less chance of suicidal completion -as effective as other agents MAOIs - CORRECT ANSWERS Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ MAOIs - CORRECT ANSWERS MOA: inhibits the enzyme monoamine oxidase which results in more serotonin, epinephrine and serotonin MAOIs - CORRECT ANSWERS SE: anticholinergic effects, potential for hypertensive crisis, durg interaction with tyramine (avoid foods containing tyramine to prevent hypertensive crisis) Cyclothymic Disorder (Cyclothymia) - CORRECT ANSWERS for at least 2 years periods of hypomanic episodes (shorter mania episode pt is feeling super excited, overconfident, and happy) and depressive episodes that do not meet full criteria for a major depressive episode Bipolar 1 - CORRECT ANSWERS -characterized by having 1 or more manic episodes -manic episode may have been preceded by and may be followed by hypomanic or depressive episodes Bipolar 2 - CORRECT ANSWERS -periods of major depression and hypomania Manic Episode - CORRECT ANSWERS -distinct period which there is abnormal and persistently elevated, expansive or irritable mood -must last at least 1 week and present most of the day every day -can be less than a week if hospitalized Diagnostic Criteria of Manic Episode - CORRECT ANSWERS AT LEAST 3 -grandiosity -decreased need for sleep -pressured speech -flight of ideas, may feel as thoughts are racing -distractibility or psychomotor agitation -increased goals in work, sex, special sphere Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Lithium Dosing - CORRECT ANSWERS Acute phase: .8-1.4 mEq/L Maintenance phase: .6 - 1.0 mEq/L Toxic effects emerge at 1.5 - 2.0 mEq/L Levels > 2 require symptomatic treatment Levels > 2.5 are considered severe toxicity Lithium SE - CORRECT ANSWERS -Usually go away in several days -GI Upset -Fine hand tremor _fatigue, muscle weakness Lithium Early to Moderate Toxicity - CORRECT ANSWERS -blood concenreation 1.5-2.0 mEq/L -course hand tremors -GI symptoms severe diarrhea -confusion -slurred speech -lack of coordination -blurred vision Lithium severe toxicity - CORRECT ANSWERS -2.5 mEq/L -coarse tremor -fever -seizure -cardiac arrhythmias -coma -death Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Nursing management of Pt on Lithium - CORRECT ANSWERS - pt education regarding sodium and water intake, side effects -monitor fluid and electrolytes imbalance -if dose is not given within the 2 hour window then skip dose -regular serum levels Pt education on Lithium - CORRECT ANSWERS -a change in salt intake can affect the therapeutic blood level - if salt intake is reduced the body will retain lithium and cause side effects and could lead to toxicity -If salt intake is increase the body will excrete lithium and have less chance of being at a therapeutic level Other meds. to use w/ Lithium to treat mania - CORRECT ANSWERS Anti- seizure Meds -Depakote (careful with teens bc it can cause increased testorone levels and cause polycystic ovary); OPTIMAL LEVELS 50-100ng/dL; fewer side effects -Carbamazepine -Lamotrigine -Gabapetin -topiramate Antisychotic Meds -Zyprexa: has mood stabilizing properties in addition to antipsychotic properties -Seroquel -Abilify Dysthmia - CORRECT ANSWERS a depressive disorder where the symptoms are generally less severe than for major depressive disorder, but are present most days and persist for at least 2 years Cross Tolerance - CORRECT ANSWERS may exist between various CNS depressants (this means a person with chronic alcoholism will need high doses of benzodiazepines to control signs of withdrawal.) Mental Health N356 Exam 2 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ substance use disorder - CORRECT ANSWERS -habitual use of disorder can lead to disorder use -use of the substance can lead to intoxication and possibly symptoms of withdrawal if the substance is taken away -use of substance in spite of negative consequences What is tolerance to drugs and how does it present in patients? - CORRECT ANSWERS with continued use more of the substance is needed to produce the same effect Alcohol Withdrawal - CORRECT ANSWERS - within 12 hrs after cessation of heavy prolonged use -course hand tremors -headache -diaphoresis -nausea -vomiting -loss of appetite -inchrease BP and HR -increased anxiety depression -feeling jumpy or nervous -irritability, insomnia, fatigue -can lead to delirium if not treated Alcohol Withdrawal - CORRECT ANSWERS -peaks 24-36 hours after cessation -seizures occur anytime, but most often within 48 hrs. delirium tremens - CORRECT ANSWERS -alcohol withdrawal delirium and tremens begin 48-72 hrs after last drink -"The horrors"