Mental Health Benchmark

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Why is suicide risk often higher after antidepressants begin working?

The client gains enough energy to carry out a suicide plan before mood fully improves.

What is the difference between Bipolar I and Bipolar II?

Bipolar I: At least one manic episode.
Bipolar II: Hypomania plus major depression (no full mania).

What are common symptoms of mania?

• Grandiosity

• Rapid speech

• Little need for sleep

• Distractibility

• Impulsive behavior

• Hyperactivity

• Poor judgment

What are the nursing priorities for mania?

• Safety

• Reduce stimulation

• Finger foods

• Encourage fluids

• Set firm limits

What is lithium used to treat?

Bipolar disorder, especially mania.

What should clients taking lithium be taught?

• Drink 2–3 L/day

• Maintain consistent sodium intake

• Never become dehydrated

• Have routine blood tests

What are early signs of lithium toxicity?

• Nausea

• Vomiting

• Diarrhea

• Tremor

What are severe signs of lithium toxicity?

• Confusion

• Ataxia

• Slurred speech

• Seizures

• Coma

What are positive symptoms of schizophrenia?

• Hallucinations

• Delusions

• Paranoia

• Disorganized speech

• Disorganized behavior

What are negative symptoms of schizophrenia?

• Flat affect

• Social withdrawal

• Poor hygiene

• Lack of motivation

• Little speech

What are extrapyramidal symptoms (EPS)?

Movement disorders caused by dopamine blockade from antipsychotics.

What is acute dystonia?

Sudden muscle spasms of the:

• Neck

• Jaw

• Tongue

• Eyes

Treatment:
Benztropine or Diphenhydramine

What is akathisia?

Inability to sit still, pacing, intense restlessness.

What is Parkinsonism?

• Tremor

• Rigidity

• Shuffling gait

• Mask-like face

What is tardive dyskinesia?

Late-onset involuntary movements:

• Lip smacking

• Tongue movements

• Grimacing

May be permanent.

What is Neuroleptic Malignant Syndrome (NMS)?

Medical emergency:

• High fever

• Severe muscle rigidity

• Confusion

• Diaphoresis

• Autonomic instability

Stop the medication and notify the provider immediately.

What are examples of SSRIs?

• Sertraline

• Fluoxetine

• Escitalopram

• Paroxetine

What disorders are SSRIs used for?

• Depression

• Anxiety

• PTSD

• OCD

• Panic disorder

• Postpartum depression

What is serotonin syndrome?

• Fever

• Agitation

• Sweating

• Tremor

• Confusion

• Muscle rigidity

Medical emergency.

What is postpartum blues?

Mild mood changes lasting up to 2 weeks after birth.

What is postpartum depression?

Persistent depression after childbirth requiring therapy and often SSRIs.

What medication treats alcohol withdrawal?

Benzodiazepines (e.g., Chlordiazepoxide [Librium], Lorazepam, Diazepam).

What are symptoms of alcohol withdrawal?

• Tremors

• Sweating

• Anxiety

• Hallucinations

• Seizures

First-line treatment for depression?

SSRIs + psychotherapy.

First-line medication for bipolar mania?

Lithium.

Medication class used for schizophrenia?

Antipsychotics

Medication used to treat acute dystonia?

Benztropine (Cogentin) or Diphenhydramine (Benadryl).

Medication class used for alcohol withdrawal?

Benzodiazepines like lorazepam, diazepam(valium) and chlordiazepoxide