ATI submission 3-4

What is the difference between BPD1 and BPD2

bpd1- experiencing or has experienced full syndrome of manic or mixed sx, or episodes of depression, lack of sleep comes first

bpd2- recurrent bouts of major depression w episodic occurrence of hypomania, never experienced full manic episode

What does splitting mean

cutting

What is common med tx. for bpd

lithium

Know info about the labs

lithium 0.6-1.2 therapeutic range

What should the nurse know about adverse effects of lamotrigine

double or blurred vision, dizziness, ha, n/v

What are the effectiveness of mood stabilizers in the bipolar pt

lithium controls episodes of acute mania or depression, and decreases incidence of suicide

What should the nurse know about caring for patient taking depakote

may cause weight loss

Depressive disorders

Priority intervention for the older adult with depressive disorders

safety and watch for suicidal ideations

What is recommended to help decrease social isolation

behavioral therapy

Pt. Teaching for ECT

100% o2 will be administered before, during and after + pt will be lying on their side to prevent aspiration

Common side effect of TCA

dry mouth, blurred vision, photophobia, urinary hesitancy or retention, constipation, tachycardia

How is admission assessment different in the suicidal pt.

look for laceration, scratches, scars or anything that could indicate attempts at self harm

rf for suicide

military/veterans, LGBTQ, MDD, BPD, personality disorder, substance abuse disorder, schizophrenia

suicide: community referrals

therapy, close family and friends, healthcare team

suicide: identifying types of nursing interventions

primary- suicide prevention through the use of community education and screenings to identify individuals at risk

secondary- suicide prevention for an individual client who is having acute suicidal crisis

tertiary- focus on providing support and assistance to survivors of a client who completed suicide

suicide: preventing injury

check for possible hazards, remove electrical wires/ shoelaces/ belts/ glass, ensure hands are always visible

medication for Depressive Disorders: priority adverse effects to report

look at TSH level (2-10)

depressive med + CI + interactions

SSRI- CI: MAOI/TCA, concurrent use can cause serotonin syndrome

SNRI- CI: MAOI, concurrent with NSAIDs, CNS depression w alcohol/ opioids/ antihistamines, sedative/hypnotics

review pt teaching for pt taking MAOI (dietary, med interactions)

avoid food with tyramine, herbal supplements, antidepressants

pt teaching Buspirone

avoid grapefruit, report unusual side effects

PTSD- epidemiological data, characteristic sx

exposure to a traumatic event or experience, avoidance, disassociate, suppress

diagnostic procedures for Bulimia nervosa

electrolyte imbalances, possible impaired liver function, elevated BUN, abnormal gc, prolonged QT interval in ECG, increase blood bicarbonate

nursing interventions when working with a pt with an ed

monitor vitals, I&O, monitor before/after meals

manifestation of anorexia nervosa

preoccupied with food and the rituals of eating, refusal to eat, fear of obesity

alcohol withdrawal- what is the indication of intoxication

judgement is disturbed, “risky behavior”

manifestation of alcohol use withdrawal

tremor of hands, tongue, eyelids, n/v, malaise, weakness, tachycardia, elevated bp, insomnia

co-dependent behaviors

partner can only control their own behavior

appropriate nursing action for suspected abuse (priority assessment)

ensure safety, maintain a non judgmental and supportive demeanor to encourage open communication

what should nurse know abt caring for a client after a barbiturate od

no antidote to reverse barbiturate toxicity, respiratory depression, sedation/drowsiness

alcohol detox

delirium withdrawal can occur 2-3 days, hallucinations, tonic-clonic seizures

cocaine withdrawal

depression, fatigue, possible occurrence of suicidal ideation, insomnia

12 step program

AA, 90 days where they accept alcoholism as an illness and promotes total absitnence as the only cure

ativan (lorazepam)

decrease risk of seizures, substitution therapy during alcohol withdrawal

med to manage alcohol withdrawal

benzodiazepines, anticonvulsants, multivitamin therapy, thiamine

disulfiram

form of behavioral modification for alcoholism

caring for client with opioid use disorder

look at pupils, effect: constricted, withdrawal: dilation

dementia

severe cognitive decline

nursing interventions for delirium and cognitive disorders

assess for risk of injury, allow reminiscing, reorient

safety considerations for a client who has alzhiermer’s disease

limit pt decision making