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Questions and Answers
What is the therapeutic serum concentration range for Lithium?
What is the therapeutic serum concentration range for Lithium?
- 1.0-2.0
- 0.6-1.2 (correct)
- 0.3-0.7
- 1.5-2.5
Which of the following is a key side effect of Lithium therapy?
Which of the following is a key side effect of Lithium therapy?
- Hyperthyroidism
- Increased appetite
- Weight gain
- Dehydration (correct)
Which condition can exacerbate Lithium toxicity?
Which condition can exacerbate Lithium toxicity?
- High sodium diet
- Increased renal function
- Dehydration (correct)
- Low potassium levels
What is Lithium primarily used to treat?
What is Lithium primarily used to treat?
Which of the following is NOT a recommendation for patients taking Lithium?
Which of the following is NOT a recommendation for patients taking Lithium?
Which drug class is known to interact with Lithium?
Which drug class is known to interact with Lithium?
What should be monitored regularly in patients on Lithium therapy?
What should be monitored regularly in patients on Lithium therapy?
What dietary advice is critical for patients taking Lithium?
What dietary advice is critical for patients taking Lithium?
Which symptom should prompt a patient on Lithium to seek immediate medical attention?
Which symptom should prompt a patient on Lithium to seek immediate medical attention?
In addition to electrolyte levels and renal function, what other patient condition needs careful monitoring when on Lithium?
In addition to electrolyte levels and renal function, what other patient condition needs careful monitoring when on Lithium?
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Study Notes
Manic Episode Treatment
- Prioritize safety and set limits on behavior
- Encourage finger foods and physical activity
Medications for Manic Episodes
- A.O.L (Antipsychotic, Olanzapine, Lithium)
- Lithium: mood stabilizer, effective for acute manic episodes
- Valproic acid: blocks "D" and treats chronic, uncontrolled mania
- Haloperidol (1st gen): blocks "D" and treats chronic, uncontrolled mania
Characteristics of High Mood
- Restlessness and flight of ideas
- Grandiosity and hyper mood
- Poor judgment and manipulative behavior
- Sleep disturbances and delusions
- Hallucinations, impulsiveness, and neglect of ADLs
- May lead to malnutrition and dehydration
Depression Treatment
- Ensure safety and set small goals leading to bigger ones
- Emphasize sleep, nutrition, and ADLs for concentration and decision-making
Antidepressants
Escitalopram (SSRI)
- Blocks serotonin reuptake
- Side effects: mood changes, worsened depression, tearfulness, discomfort, and self-destructive behavior
Venlafaxine (SNRI)
- Blocks serotonin and norepinephrine reuptake
- Side effects: serotonin syndrome, sexual dysfunction, stomach issues, fever, and swelling
- Take at sunrise to minimize side effects
- Gradually taper to avoid discontinuation syndrome
Valproic Acid
- Mechanism of action: blocks "D"
- Side effects: GI upset, liver impairment, prolonged bleeding, rash, and blurred vision
- Precautions: take at night, position slowly, take with food, and avoid sudden stop and alcohol
Haloperidol 1st gen
- Mechanism of action: blocks "D"
- Side effects: orthostatic hypotension, tardive dyskinesia, restlessness, muscle twitching, and Parkinson's disease
- Precautions: increase food intake, avoid sudden stop, and avoid alcohol
Nursing Considerations
- Monitor liver function, platelets, and bleeding risk
- Assess mental status and weight
- Ensure safety and monitor suicide risk
- Teach patients to prioritize sleep, nutrition, and ADLs
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