NCLEX Review: Mental Health Disorders Anxiety Disorders Generalized Anxiety Disorder (GAD) Excessive worry lasting 6 months or more Symptoms: Restlessness Muscle tension Fatigue Poor concentration Sleep disturbance Panic Disorder Sudden intense fear with: Chest pain Palpitations Shortness of breath Feeling of doom Nursing: Stay with client Calm environment Short/simple communication Phobias Irrational fear of object/situation Treatment: Exposure therapy CBT SSRIs sometimes used OCD (Obsessive-Compulsive Disorder) Obsessions = intrusive thoughts Compulsions = repetitive behaviors to reduce anxiety Nursing: Do not suddenly stop rituals Set limits gradually Encourage coping skills PTSD Triggered after traumatic event Symptoms: Flashbacks Hypervigilance Nightmares Avoidance Priority: Safety Trauma-informed care Depression Disorders Major Depressive Disorder Symptoms SIGECAPS: Sleep changes Interest loss Guilt Energy low Concentration poor Appetite changes Psychomotor changes Suicidal thoughts Nursing Priorities Suicide assessment Nutrition/hydration Sleep/rest Medication adherence Medications SSRIs Examples: Sertraline Fluoxetine Teachings: Takes weeks to work Do not stop abruptly Watch for serotonin syndrome Serotonin Syndrome Symptoms: Agitation Fever Tremor Hyperreflexia Diarrhea Bipolar Disorder Mania Symptoms Mnemonic: DIG FAST Distractibility Indiscretion Grandiosity Flight of ideas Activity increased Sleep deficit Talkative Nursing Care Reduce stimulation Set firm limits High-calorie finger foods Encourage rest Medications Mood Stabilizers Lithium Anticonvulsants Lithium Toxicity Therapeutic level: 0.6–1.2 mEq/L Toxic signs: Tremor Vomiting Confusion Ataxia Severe diarrhea Important: Maintain sodium/fluid intake Dehydration increases toxicity risk Schizophrenia Spectrum Disorders Positive Symptoms Things added: Hallucinations Delusions Paranoia Disorganized speech Negative Symptoms Things lost: Flat affect Social withdrawal Anhedonia Lack of motivation Hallucination Nursing Response Present reality “I do not hear the voices.” Assess for command hallucinations Delusions Do NOT argue. Respond: “I understand this feels real to you.” Antipsychotics First Generation Haloperidol Risk: EPS Tardive dyskinesia Neuroleptic malignant syndrome (NMS) Second Generation Olanzapine Risperidone Risk: Weight gain Diabetes Metabolic syndrome EPS Symptoms Acute dystonia Akathisia Parkinsonism Tardive dyskinesia Treatment: Benztropine Diphenhydramine Neuroleptic Malignant Syndrome Medical emergency: Fever Rigidity Confusion Elevated CK Personality Disorders Cluster A Odd/eccentric Paranoid Schizoid Schizotypal Cluster B Dramatic/emotional Antisocial Borderline Histrionic Narcissistic Borderline Personality Disorder Fear of abandonment Splitting staff Self-harm risk Nursing: Consistent boundaries Team communication Cluster C Anxious/fearful Avoidant Dependent Obsessive-compulsive personality disorder Eating Disorders Anorexia Nervosa Severe restriction Distorted body image Bradycardia Electrolyte imbalance Priority: Monitor cardiac status Daily weights Observe after meals Bulimia Nervosa Binge/purge behavior Normal weight often seen Complications: Hypokalemia Dental erosion Substance Use Disorders Alcohol Withdrawal Starts within hours after last drinkd

Fluoxetine T300 26-27

Fluoxetine Counseling Rubric

Fluoxetine Counseling Rubric

fluoxetine

Analgesics (Pain Relievers) • Acetaminophen • Hydrocodone • Codeine Antacids/Anti-ulcer (GERD treatment) • Esomeprazole • Calcium carbonate • Famotidine Antibiotics (Bacterial Infections) • Amoxicillin • Ciprofloxacin • Sulfamethoxazole Anticholinergics (Smooth Muscle Spasms) • Ipratropium • Dicyclomine • Hyoscyamine Anticoagulants (Blood Thinners - Delay Clotting) • Warfarin • Apixaban • Heparin Anticonvulsants (Prevent/Control Seizures) • Clonazepam • Phenytoin • Gabapentin Antidepressants (Relieve Depression) • Doxepin • Fluoxetine • Duloxetine • Selegiline Antidiarrheals (Reduce Diarrhea) • Bismuth subsalicylate • Loperamide • Diphenoxylate/atropine Antiemetics (Reduce Nausea/Vomiting) • Metoclopramide • Ondansetron Antifungals (Fungal Infections) • Fluconazole • Nystatin • Miconazole Antihistamines (Relieve Allergies) • Diphenhydramine • Cetirizine • Loratadine Antihypertensives (Lower Blood Pressure) • Metoprolol • Lisinopril • Valsartan • Clonidine Anti-inflammatories (Reduce Inflammation) • Ibuprofen • Celecoxib • Naproxen Antilipemics (Lower Cholesterol) • Atorvastatin • Fenofibrate • Cholestyramine Antimigraine Agents (Relieve Migraines) • Topiramate • Sumatriptan • Rizatriptan • Zolmitriptan Anti-osteoporosis Agents (Improve Bone Density) • Alendronate • Raloxifene • Calcitonin Antipsychotics (Psychosis Treatment) • Quetiapine • Haloperidol • Risperidone Antipyretics (Reduce Fever) • Acetaminophen • Ibuprofen • Aspirin Skeletal Muscle Relaxants (Reduce/Prevent Muscle Spasms) • Cyclobenzaprine • Methocarbamol • Carisoprodol Antitussives/Expectorants (Cough/Mucus Relief) • Dextromethorphan • Codeine • Guaifenesin Antivirals (Viral Infections) • Acyclovir • Interferon • Oseltamivir Anxiolytics (Reduce Anxiety - Anti-Anxiety) • Clonazepam • Diazepam • Lorazepam Bronchodilators (Relax Airway Muscles - Asthma, COPD) • Albuterol • Isoproterenol • Theophylline CNS Stimulants (Reduce Hyperactivity - ADHD, Narcolepsy) • Methylphenidate • Dextroamphetamine • Lisdexamfetamine Contraceptives (Prevent Pregnancy) • Medroxyprogesterone acetate • Ethinyl estradiol • Drospirenone Decongestants (Relieve Nasal Congestion) • Pseudoephedrine • Phenylephrine • Oxymetazoline Diuretics (Eliminate Excess Fluid - Treats Hypertension & Edema) • Furosemide • Hydrochlorothiazide • Bumetanide Hormone Replacements (Stabilize Hormone Deficiencies - Thyroid, Diabetes, Menopause) • Levothyroxine • Insulin • Desmopressin • Estrogen Laxatives & Stool Softeners (Promote Bowel Movements) • Magnesium hydroxide • Bisacodyl • Docusate sodium Oral Hypoglycemics (Reduce Blood Glucose - Diabetes Treatment) • Metformin • Glyburide • Pioglitazone Sedative-Hypnotics (Induce Sleep/Relaxation - Insomnia, Anxiety) • Zolpidem • Temazepam • Eszopiclone Bo

Chapter 23: Fluoxetine & Lithium

Chapter 23: Fluoxetine & Lithium (copy)

Fluoxetine, furosemide, Metropolol, spironolactone, Heparin, enoxaparin, warfarin

Fluoxetine

Chapter 28: Chemical Messengers: Hormones, Neurotransmitters, and Drugs