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NUR 326 Exam 1 Psych MH Spring 2025 Lee
ASU questions with correct answers
Acute/Inpatient |MH |practice |settings |- |VERIFIED |ANSWER✔✔--provides |intensive |treatment |and | supervision |in |locked |units |for |clients |who |have |severe |mental |illness, |who |present |a |danger |to |self | or |to |others -care |helps |stabilize |mental |illness |manifestations |and |promotes |the |clients |rapid |return |to |the | community -staff |is |made |up |of |an |interprofessional |team |with |management |provided |by |nurses |developing | individualized |plants |that |are |client |and |family |centered -residential |and |hospital |centers -Community |settings |are |not |enough |so |need |to |upgrade |to |inpatient Outpatient |MH |practice |settings |- |VERIFIED |ANSWER✔✔--includes |community |settings |(ex. |clinics, | schools, |day-care |centers, |partial |hospitalization |programs, |substance |treatment |facilities, |forensic | settings, |psychosocial |rehabilitation |programs, |telephone |crisis |counseling |centers, |home |health) -nurses |help |to |stabilize |or |improve |clients' |mental |functioning |within |a |community; |teach |support | and |make |referrals |in |order |to |promote |positive |social |activities -nursing |interventions |in |community |settings |provide |for |primary |treatment |as |well |as |primary, | secondary, |and |tertiary |prevention |of |mental |illness -assertive |programs→ |try |to |prevent |hospitalizations, |resources |to |house Criteria |to |justify |admission |to |an |acute |care |facility |- |VERIFIED |ANSWER✔✔--A |clear |risk |of |the | client's |danger |to |self |or |others -An |inability |to |meet |own |basic |needs -Failure |to |meet |expected |outcomes |of |community-based |treatment -A |dangerous |decline |in |the |mental |health |status |of |a |client |undergoing |long-term |treatment -A |client |having |a |medical |need |in |addition |to |a |mental |illness -Decrease |in |BADLs -Deny |having |an |issue -Goals |of |acute |mental |health |treatment |include |the |following: |prevention |of |the |client |harming |self | or |others; |stabilizing |mental |health |crises; |return |of |clients |who |are |severally |ill |to |some |type |of | community |care
Concepts |of |therapeutic |communication |- |VERIFIED |ANSWER✔✔--silence, |accepting, |giving | recognition, |offering |self, |giving |broad |openings, |restating, |encouraging |comparison, |reflecting, |giving | information, |seeking |clarification, |summarizing, |encouraging |plan |of |action, |touch?, |etc. -Client |centered, |purposeful, |planned, |goal-directed -Elicit |and |attend |to |client |thoughts, |feelings, |concerns |and |needs -Express |empathy |and |genuine |concern -Obtain |information |and |give |feedback |about |the |client's |condition -Intervene |to |promote |functional |behavior |and |effective |interpersonal |relationships -Evaluate |the |client's |progress |toward |goals |and |outcomes -Plan |for |and |allow |adequate |time |to |communicate; |clients |who |have |certain |mental |health |disorders | (major |depressive |disorder |or |schizophrenia) |can |require |a |longer |period |of |time |to |respond |to | questions. -attending |behaviors |or |active |listening |(ex. |nonverbal |cues), |time, |caring |attitude, |honesty, |empathy, | non |judgemental |attitude, |trust -Clarifying |techniques: |restating, |reflecting, |paraphrasing, |exploring -Offering |self -Presenting |reality -Voicing |doubt -If |they |are |having |delusions |understand |but |don't |accept |that |it's |true Types |of |questions |of |therapeutic |communication |- |VERIFIED |ANSWER✔✔--Closed-ended |questions: | Helpful |if |used |sparingly |during |the |initial |interaction |to |obtain |specific |data. |Avoid |using |repeated | closed-ended |questions |which |can |block |further |communication. -Projective |questions: |Uses |"what |if" |or |similar |questions |to |assist |clients |in |exploring |feelings |and |to | gain |greater |understanding |of |problems |and |possible |solutions -Presupposition |questions: |Explores |the |client's |life |goals |or |motivations |by |presenting |a |hypothetical | situation |in |which |the |client |no |longer |has |the |mental |health |disorder -Open-ended |questions: |Facilitates |spontaneous |responses |and |interactive |discussion Barriers |to |effective |communication |- |VERIFIED |ANSWER✔✔--asking |irrelevant |personal |questions -offering |personal |opinions -giving |advice -false |reassurance -minimizing |feelings
-This |can |be |imposed |by |a |family |member, |legal |guardian, |primary |care |provider, |or |a |mental |health | provider. The |client |can |request |a |legal |review |of |the |admission |at |any |time. -An |involuntary |admission |is |limited |to | 60 |days |at |which |time |a |psychiatric |and |legal |review |of |the | admission |is |required. -Capacity |is |ability |to |make |decision, |competency |can |only |be |deemed |in |court -Advanced |directive |for |MH |(would |have |been |made |before |being |deemed |incompetent) |would |be | first |if |admitted |involuntarily |and |deemed |incompetent seclusion |and |restraints |- |VERIFIED |ANSWER✔✔--can |be |voluntary |"quiet |room" -least |restrictive |measures, |shortest |duration |necessary -provider |must |prescribe |in |writing time |limits --age | 18 |and |order→ | 4 |hr --age |9-17→ | 2 |hr --age | 8 |and |younger→ |1hr -Must |offer |food, |water, |toileting, |monitored |for |pain |and |vitals -document |Q15-30 |min -Less |restrictive |measures --Verbal |interventions |(encouraging |the |client |to |calm |down) --Diversion |or |redirection --Providing |a |calm, |quiet |environment --Offering |a |PRN |medication |(though |technically |a |chemical |restraint, |medications |are |considered |less | restrictive |than |a |mechanical |restraint) -The |nurse |can |use |seclusion |or |restraints |without |first |obtaining |a |provider's |written |prescription |if |it |is |an |emergency |situation. |If |this |emergency |treatment |is |initiated, |the |nurse |must |obtain |the |written |prescription |within |a |specified |period |of |time |(usually | 15 |to | 30 |min). -Restraint |or |seclusion |must |be |discontinued |when |the |client |is |exhibiting |behavior |that |is |safer |and | quieter. |Once |restraints |or |seclusion |are |discontinued, |the |nurse |must |obtain |a |new |prescription | before |initiating |restraints |again assault |- |VERIFIED |ANSWER✔✔-making |a |threat |(ex. |approaching |client |in |threatening |manner |with | syringe |in |hand)
battery |- |VERIFIED |ANSWER✔✔-touching |a |client |in |a |harmful |or |offensive |way |(ex. |gave |syringe | injection |against |client |will) veracity |- |VERIFIED |ANSWER✔✔-truthfulness fidelity |- |VERIFIED |ANSWER✔✔-faithfulness; |loyalty reaction |formation |- |VERIFIED |ANSWER✔✔-unacceptable |feelings |or |behaviors |are |controlled |or |kept | out |of |awareness |by |overcompensating |or |demonstrating; |overcompensating |or |demonstrating |the | opposite |behavior |is |what |is |felt -adaptive: |person |trying |to |quit |smoking |repeatedly |talks |to |adolescents |about |the |dangers |of | nicotine -maladaptive: |person |who |resent |having |to |care |for |an |aging |population |becomes |overprotective |and | restricts |their |freedoms projection |- |VERIFIED |ANSWER✔✔-attributing |one's |unacceptable |thoughts |and |feelings |onto |another |who |does |not |have |them -adaptive: |n/a -maladaptive: |married |client |who |is |attracted |to |another |person |accuses |their |partner |of |having |an | affair dissociation |- |VERIFIED |ANSWER✔✔-a |disruptions |in |consciousness, |memory, |identity, |or |perception | of |the |environment |that |results |in |compartmentalization |of |uncomfortable |or |unpleasant |aspects |of | oneself -adaptive: |a |parent |blocks |out |the |distracting |noise |of |their |children |in |order |to |focus |while |driving |in | traffic -maladaptive: |person |forgets |who |they |are |following |a |sexual |assault milieu |therapy |- |VERIFIED |ANSWER✔✔--moral |treatment; |focuses |on |modifying |or |controlling |the | immediate |environment, |also |focuses |on |social |and |physical |settings; |management |of |the |milieu | refers |to |the |management |of |the |total |environment |of |the |mental |health |unit |in |order |to |provide |the |least |amount |of |stress, |while |promoting |the |greatest |benefit |for |all |the |clients -safety |is |main |priority -nurse |is |manager |of |care, |therefore |is |responsible |for |structuring |and/or |implementing |aspects |of |the |therapeutic |milieu |(ex. |regular |community |meetings |including |clients |and |nursing |staff)
therapeutic |milieu: |emotional |climate |- |VERIFIED |ANSWER✔✔--clients |should |feel |safe |from |self |harm |and |harm |from |other |clients -clients |should |feel |cared |for |and |accepted |by |staff |and |others Nursing |interventions |to |ensure |physical |safety |within |the |milieu |- |VERIFIED |ANSWER✔✔--no |access | to |harmful |objects, |monitoring |of |locked |areas, |monitoring |of |visitors, |restriction |of |sexual |activity |or | inappropriate |boundaries, |deterrence |of |elopement, |rapid |de-escalation |of |disruptive |or |violent | behaviors -Planning |of |the |milieu |begins |from |admission |- |room |assignments |- |roommates?, |personalities, | likelihood |of |nighttime |disruptions, |mental |health |and |medical |diagnoses, |two |clients |with |severe | hallucinations |versus |two |patients |detoxing -special |safety |features -nurse's |station |and |other |areas |should |be |placed |to |allow |for |easy |observation |of |clients |by |staff |and |access |to |staff |by |clients -seclusion |rooms |and |restraints |should |be |set |up |for |safety |and |used |only |after |all |less |restrictive | measures |have |been |exhausted -teach |fire, |evacuation, |and |other |safety |rules |to |all |staff |(clear |plans |for |keeping |clients |and |staff |safe |in |emergencies; |maintain |staff |skills |like |CPR) -considerations |of |room |assignments |on |a | 24 |hour |care |unit -personalities |of |each |roommate -likelihood |of |nighttime |disruptions |for |a |roommate |if |one |client |has |difficulty |sleeping -MH |and |medical |diagnoses |(ex. |how | 2 |clients |with |severe |paranoia |may |interact |with |each |other) Boundaries |of |the |nurse-client |therapeutic |relationship |- |VERIFIED |ANSWER✔✔-1. |Relationships |slips | into |a |social |context -Social |relationship: |Primary |purpose |is |for |socialization |or |friendship |with |a |focus |on |the |mutual | needs |of |the |individuals |involved |in |the |relationship. -Therapeutic |relationship: |Primary |purpose |is |to |identify |the |client's |problems |or |needs |and |then | focus |on |assisting |the |client |in |meeting |or |resolving |those |issues
- |The |nurse's |needs |(for |attention, |affection, |or |emotional |support) |are |met |at |the |expense |of |the | patient's |needs Nurse-client |relationship |- |VERIFIED |ANSWER✔✔--focus |on |client's |ideas, |experiences, |and |feelings -identify |and |explore |the |client's |needs |and |problems -discuss |problem |solving |alternatives |with |the |client -help |to |develop |the |client's |strengths |and |new |coping |skills
-encourage |positive |behavior |changes |in |the |client -assist |the |client |to |develop |a |sense |of |autonomy |and |self-reliance -portray |genuineness, |empathy, |and |a |positive |regard |toward |the |client; |practice |empathy |by | remaining |non |judgemental; |and |attempting |to |understand |the |client's |actions |and |feelings, |this | differs |from |sympathy |where |the |nurse |allows |oneself |to |feel |the |way |the |client |does |and |is |non | therapeutic Transference |- |VERIFIED |ANSWER✔✔-client |views |member |as |having |characteristics |of |another | person |who |has |been |significant |to |the |client's |personal |life |(ex. |client |sees |nurse |like |a |parent) -client |expects |exclusive |services |from |nurse |(ex. |extra |session |time) -client |demonstrates |jealousy |of |the |nurse's |time |or |attention -client |compares |the |nurse |to |a |former |authority |figure -transference |by |a |client |is |more |likely |to |occur |with |a |person |in |authority Countertransference |- |VERIFIED |ANSWER✔✔-member |views |client |as |having |characteristics |of | another |person |in |their |past |(ex. |client |reminds |nurse |of |friend |who |elicited |feelings |of |defensiveness | and |anger) -nurse |overly |identifies |with |client -nurse |competes |with |client -nurse |argues |with |client -clients |who |induce |very |strong |personal |feelings |can |become |objects |of |countertransference Risk |factors |for |depression/mood |disorders |- |VERIFIED |ANSWER✔✔--Women -Stress, |trauma, |neglect, |abuse, |postpartum |(within | 4 |wks), |family |hx -Comorbid |anxiety |or |substance |related |disorders -Comorbid |medical |and |mental |health |disorders -Personality |disorders -Imbalances |of |the |neurotransmitters |norepinephrine, |dopamine, |acetylcholine, |GABA, |and |possibly | glutamate |can |play |a |role |in |the |occurrence |of |depression --Serotonin |- |affect |mood, |sexual |behavior, |sleep, |hunger, |pain |perception --Norepinephrine |- |affect |attention |and |behavior
Risk |factors |for |suicide |- |VERIFIED |ANSWER✔✔--stating |they |want |to |die |or |kill |themselves -they |feel |hopeless |or |empty |with |no |reason |to |live -they |feel |trapped |without |solutions |to |problems -they |feel |physical |and |emotional |pain |that |is |unbearable -they |feel |like |a |burden |to |others -social |withdrawal -giving |away |loved |possessions -bidding |goodbye |to |friends |and |family |(arranging |affairs) -engage |in |risky |behavior |(ex. |fast |driving) -obsessively |thinking |and |talking |about |death -sudden |euthymia |(relief |of |making |the |decision |to |commit) -experiencing |mania |(energy |to |commit) -individual |→ |previous |self |harm |attempts, |mental |illness, |lacking |social |support, |legal |problems, | financial |problems, |risky |and |impulsive |behaviors, |loss |of |job |serious |medical |illness, |use |of | substances, |few |protective |factors, |starting |antidepressants -relationship |→ |history |of |abuse/neglect, |bullying, |family |history |of |suicide, |personal |relationship | problems, |sexual |violence -community |→ |barriers |to |access |health |care, |cultural/religious |beliefs, |community |cluster |of |suicides -societal |→ |stigma |with |mental |illness |or |help-seeking, |access |to |lethal |weapons/medications, |media | portrayals |of |suicide -populations |at |risk→ |People |over |the |age |of |60, |2nd |leading |cause |of |death |among |ages |10-34, | especially |in |20s, |health |care |workers, |first |responders, |and |military |have |higher |rates |than |general | population, |Native |Americans, |those |identifying |as |lesbian |or |gay -Low |mood, |high |energy |and |cognition=high |risk Protective |factors |for |suicide |- |VERIFIED |ANSWER✔✔--Current |pregnancy -Religious |and |cultural |beliefs -Overall |satisfaction |with |life -Presence |of |adequate |social |support -Effective |coping |and |problem-solving |skills -Access |to |adequate |medical |care -Feelings |of |responsibility |toward |partner |and |children
Short-form | 6 |question |C-SSRS |- |VERIFIED |ANSWER✔✔-1. |Have |you |wished |you |were |dead |or |wished | you |could |go |to |sleep |and |not |wake |up?
- |Have |you |actually |had |any |thoughts |of |killing |yourself? If |YES |to |2, |ask |questions |3, |4, |5, |and |6. |--If |NO |to |2, |go |directly |to |question |6.
- |Have |you |been |thinking |about |how |you |might |do |this? |(E.g. |"I |thought |about |taking |an |overdose | but |I |never |made |a |specific |plan |as |to |when, |where, |or |how |I |would |actually |do |it....and |I |would | never |go |through |with |it.")
- |Have |you |had |these |thoughts |and |had |some |intention |of |acting |on |them? |(As |opposed |to |"I |have | the |thoughts |but |I |definitely |will |not |do |anything |about |them.")
- |Have |you |started |to |work |out |or |worked |out |the |details |of |how |to |kill |yourself? |Do |you |intend |to | carry |out |this |plan?
- |Have |you |ever |done |anything, |started |to |do |anything, |or |prepared |to |do |anything |to |end |your |life? |(ex. |collected |pills, |obtained |a |gun, |etc.) --If |YES, |ask: |Was |this |within |the |past |three |months? Nursing |interventions |for |clients |at |risk |for |suicide |or |self-harm |- |VERIFIED |ANSWER✔✔--provide | therapeutic |milieu |→ |safe |environment -Start |with |least |invasive |depending |on |the |degree |of |risk |for |violence -MD |Orders |needed -1:1 |Observation -15-minute |checks |(usually |standard |if |in-patient) |- |inappropriate |if |there |was |an |attempt -Safety |contracting |is |not |something |we |do |- |this |was |an |old |method |of |having |a |patient |sign |a | contract |saying |they |won't |harm |themselves, |no |evidence |to |support |a |decreased |incidence |of | attempts |or |completed |suicide -Safety |planning |instead -Environmental |Assessment -Bags |in |waste |baskets, |blankets, |curtains, |IVs, |nasal |cannulas, |doors |attached |with |magnets |- |no | doorknobs -No |soda |cans, |pens/pencils, |cords |of |any |kind -Special |food |trays |- |soft |plates |and |cups, |finger |foods |only |(no |utensils) |- |most |restrictive, |less | restrictive |would |be |plastic |utensils, |all |utensils |must |be |accounted |for Expected |findings |among |clients |experiencing |mild/moderate |and |severe/panic |levels |of |anxiety |- | VERIFIED |ANSWER✔✔-Mild |anxiety→ |can |be |motivational, |restless, |seeking |attention, |requiring | approval |or |reassurance; |ability |to |function |is |heightened, |more |focused |(ex. |before |an |exam)
cannot |concentrate |or |learn, |keep |in |mind |when |providing |interventions -relaxation |training -modeling→ |appropriate |demonstration -systematic |desensitization→ |for |phobias flooding -response |prevention→ |dont |do |compulsive |behavior |if |in |contact |with |item -stopping→ |goal |to |say |it |in |head -anxiety |is |a |subjective |experience |that |is |characterized |by |objective |findings -fight |or |flight |normally |good, |but |becomes |bad |when |maladaptive |and |impairs |functional |ability Types |of |bipolar |disorders |- |VERIFIED |ANSWER✔✔-cyclothymic |disorder |→ |lesser |form |of |bipolar |with |client |exhibiting |hypomanic |symptoms |and |depressive |symptoms |(minor |depression) |for |at |least | 2 | years |(does |not |meet |DSM-5-TR |criteria) premenstrual |dysphoric |disorder |→ |group |of |manifestations |that |occur |only |in |the |last |week |before | menstruation rapid |cycling→ |at |least | 4 |episodes |in |a |year, |high |recurrence |rate |and |hard |to |treat Bipolar |I→ |acute |mania |with |major |depressive |(delusions |and |hallucinations; |at |least | 1 |wk) Bipolar |II→ |one |or |more |hypomania |with |major |depressive |(at |least | 4 |days) I |& |II |can |both |be |diagnosed |after |one |episode |of |mania |(at |least |one |week), |before |depressive | episode Mania→ |abnormally |elevated |mood, |irritable, |or |expansive; |acute |manic |episode |requires | hospitalization |(at |least |one |week) Hypomania→less |severe |episode |of |mania |(4 |days); |may |progress |to |mania Expected |findings |among |clients |with |bipolar |disorders |- |VERIFIED |ANSWER✔✔--elevated |expansive | mood
-high |inflated |self |esteem -risky |impulsive |behaviors -participate |in |activities |that |they |did |not |previously |(dangerous |activities) -delusions |and |hallucinations -euphoria -grandiosities→ |inflated |sense |of |self -persecutory |delusions→ |paranoia -anger, |rage, |agitated -social |intrusiveness -increased |sexual |desire -chaotic -verbose |speech |(stop |talking |or |pressured |speech) -violence, |suicidality, |hostility -less |sleep -easily |distracted |and |impulsive -lack |of |insight |and |loose |associations -circumstantial |and |tangential |speech -flight |of |ideas, |pressured |speech -labile |mood -clang |associations |(rhyming) -neglect |of |ADLs |including |nutrition |and |hydration -attention |seeking |behavior -denial |of |illness -hypomania: |feel |high |and |less |of |perceptual |disturbances |and |impairment (Depression) -Flat, |blunted, |labile |affect -Tearfulness, |crying -Lack |of |energy
-sleep |disturbances |can |happen |at |any |time -convey |acceptance |of |false |belief |but |that |you |do |not |share |this |belief -don't |bring |up |the |past |(act |like |it |didn't |happen) -protect |clients |from |poor |judgment |and |impulsive |behavior |(ex. |giving |money |away |and |sexual | indiscretions) -supervise |choice |of |clothes -step |by |step |reminders |for |hygiene |and |stress -provide |consistency |with |expectations -risk |for |relapse: |alcohol, |cocaine, |caffeine, |sleep |disturbances, |psychological |stressors Nursing |role |in |reporting |abuse/neglect |- |VERIFIED |ANSWER✔✔--mandated |reporting -duty |to |warn -vulnerable |adult→ |anyone | 18 |and |up |with |a |mental |or |physical |disability |and |cannot |protect | themselves -let |child |know |you |are |talking |to |CPS |but |not |obligated |to |tell |parent -document |subjective |and |objective |data -separate |suspected |victim |from |abuser -develop |safety |plan Expected |findings |among |clients |experiencing |abuse |- |VERIFIED |ANSWER✔✔--not |be |able |to |recall | events |or |stories |are |not |aligning |with |physical |injury -may |be |afraid |to |provide |events -upon |examination, |old |to |new -various |stages |of |healing -TBI |to |infants -shaken |baby |syndrome |(bulging |fontanels, |increased |head |circumference, |inc |resp |distress, |internal | bleeding) -glove |marks, |cig |marks, |belt |buckle |shapes -bruising |before | 6 |mo |is |suspicious -unusual |bruising |on |back, |or |abdomen -spiral |fracture |indicative |of |arm |being |pulled |too |hard |poss |dislocation -human |bite |marks
Nursing |interventions |in |the |care |of |clients |experiencing |abuse |- |VERIFIED |ANSWER✔✔--treat | underlying |med |condition -safe |house -emotional |support -decrease |stigma -develop |safety |plan -discuss |therapies |that |could |be |beneficial -encourage |participation |in |support |groups recognize |cues |of |potential |violence |from |clients |- |VERIFIED |ANSWER✔✔--hyperactivity |such |as | pacing, |restlessness -hypersensitivity, |easily |offended -eye |contact |that |is |intense, |or |no |eye |contact |at |all -facial |expressions |(frowning |or |grimacing) -body |language |(clenching |fists, |waving |arms) -rapid |breathing -aggressive |postures |(leaning |forward, |appearing |tense) -verbal |cues |(loud, |rapid |talking, |yelling |and |shouting) -drug |or |alcohol |intoxication -Anger |becomes |negative |when |it |is |denied, |suppressed |or |expressed |inappropriately |- |a |client |who |is |often |angry |and |aggressive |can |have |underlying |feelings |of |inadequacy, |insecurity, |guilt, |fear, |and | rejection -decline |to |eat |or |drink -attempt |to |leave |before |discharge risk |factors |for |potential |violence |from |clients |- |VERIFIED |ANSWER✔✔--hx |of |aggression, |poor |impulse |control, |and |violence -poor |coping |skills, |limited |support |systems -comorbidity |that |leads |to |acts |of |violence |and |severe |morbidity -living |in |a |violent |environment -limit |setting |by |the |nurse |with |the |therapeutic |milieu -early |age |of |onset |of |psychiatric |symptoms
Adverse |Drug |Rxns: |anticholinergic |effects |(dryness, |blurred |vision, |glaucoma, |urinary |retention, | constipation); |CNS |depression |(drowsiness, |sedation, |orthostatic |hypotension, |tachycardia) -High |risk |of |OD: |life-threatening |dysrhythmias, |confusion, |seizures -Narrow |therapeutic |index |(black |box |warning→ |suicide) Contraindications/Precautions: |cardiac/seizure |history, |liver |or |renal |disorders, |urinary |retentions, |DM, |alcoholism Interactions: |CNS |depressants; |MAOIs→ |hypertensive |crisis |& |inc. |serotonin; |anticholinergics | (antihistamines); |ritalin |inc. |level |of |TCAs; |St. |John's |Wort |(inc. |serotonin), |kava-kava |& |valerian |root | (CNS |depression); |amitriptyline, |doxepin |for |anxiety |- |potential |for |lethal |overdose Client |Education: |do |not |stop |abruptly, |take |at |bedtime SSRIs |(selective |serotonin |reuptake |inhibitors) ex. |escitalopram |(Lexapro), |fluoxetine |(Prozac), |sertraline |(Zoloft) |- |VERIFIED |ANSWER✔✔- Pharmacologic |Action: |blocks |reuptake |of |serotonin Adverse |Drug |Rxns: |CNS |excitement |(insomnia, |nervousness, |sexual |dysfunction, |headache); |nausea, | GI |upset, |wt. |gain; |hyponatremia |(causes |inc. |in |ADH |which |causes |excretion |of |Na+) -SSSS→ |stomach |upset, |sexual |dysfunction, |serotonin |syndrome, |SI Contraindications/Precautions: |liver |disease, |DM, |hyponatremia, |cardiac |disease, |SI | Interactions: |MAOIs |within | 2 |weeks; |St. |John's |Wort→ |serotonin |syndrome; |discontinuation |syndrome |- |sertraline |or |fluoxetine Client |Education: |take |in |the |morning |with |food |for |GI |upset; |report |impotence |or |decreased |libido; | S/S |of |hyponatremia; |do |not |stop |abruptly; |inc. |risk |of |GI |bleed SNRIs |(serotonin-norepinephrine |reuptake |inhibitors) ex. |venlafaxine |(Effexor |ER) |& |duloxetine |(Cymbalta) |- |VERIFIED |ANSWER✔✔-Pharmacologic |Action: | block |uptake |of |norepinephrine |and |serotonin
Adverse |Drug |Rxns: |CNS |excitement |(insomnia |& |nervousness); |nausea, |GI |upset, |Hepatitis; | hyponatremia |(inc. |ADH) Contraindications/Precautions: |cardiac |disease, |HTN, |liver/kidney |disease, |SI Interactions: |MAOIs |within | 2 |weeks; |St. |John's |Wort→ |serotonin |syndrome; |discontinuation |syndrome |- |venlafaxine |or |Effexor Client |Education: |take |with |food; |avoid |taking |close |to |bedtime; |monitor |BP; |do |not |stop |taking | abruptly MAOIs |(monoamine |oxidase |inhibitors) ex. |phenelzine |(Nardil) |& |tranylcypromine |(Parnate) |- |VERIFIED |ANSWER✔✔-Pharmacologic |Action: | block |substances |that |inactive |serotonin, |norepinephrine, |and |dopamine; |increasing |amounts |of |these |neurotransmitters Adverse |Drug |Rxns: |CNS |excitement |(agitation, |anxiety, |insomnia); |ortho. |HOTN; |GI |upset; |N/V; |liver/kidney |issues Contraindications/Precautions: |SI, |liver/renal |disorders, |cardiac |disease, |glaucoma, |substance |abuse | disorder, |epilepsy |(inc |risk |for |seizures), |DM, |schizophrenia |(inc |in |dopamine |from |MAOI), |mania Interactions: |foods |containing |tyramine, |TCAs, |sympathomimetics |(OTC |cold |preparations |that |contain |ephedrine, |illegal |street |drugs, |cocaine, |amphetamines)→ |hypertensive |crisis |(chest |pain, |headache, | confusion, |blurred |vision, |N/V, |anxiety, |SOB, |heart |palpitations, |bloody |nose, |seizure, | unresponsiveness); |tranylcypromine |(paranate) |and |phenelzine |(Nardil) |- |hypertensive |crisis |with | tyramine |- |sweating, |dilated |pupils, |hyperthermia, |N/V, |palpitations Client |Education: |list |of |foods, |monitor |for |agitation, |ortho. |HOTN |safety, |caution |with |other |meds; | can |cause |liver |or |renal |failure Foods |with |tyramine: |ripe |avocados, |figs, |fermented |or |smoked |meats, |liver, |dried |or |cured |fish, |most |cheeses, |some |beer |and |wine, |and |protein |dietary |supplements
