Medication Discontinuation and Serotonin Syndrome Quiz

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Questions and Answers

What is the purpose of administering muscle relaxants during the procedure described?

To stimulate brain activity

To prevent bone fractures

To prevent severe muscle contraction during seizures (correct)

To induce seizures

Which anesthetic agents are commonly used during the procedure?

Lidocaine and midazolam

Ketamine and sevoflurane

Phenobarbital and fentanyl

Methohexital and propofol (correct)

What is the purpose of administering succinylcholine (Anectine) during the procedure?

To induce respiratory muscle paralysis

To prevent severe muscle contraction during seizures (correct)

To induce relaxation

To stimulate muscle contractions

Where are the electrodes typically placed for bilateral ECT?

On both sides of the head Signup and view all the answers

What distinguishes unilateral ECT from bilateral ECT in terms of electrode placement?

Unilateral ECT places electrodes only on one side of the head Signup and view all the answers

Why is 100% oxygen administered throughout the procedure described?

To prevent oxygen deficiency during seizures Signup and view all the answers

What is the primary mechanism of action of typical antipsychotics like haloperidol?

Block dopamine receptors in the basal ganglia Signup and view all the answers

Which type of antipsychotic medications are more effective for negative symptoms of schizophrenia?

Atypical antipsychotics Signup and view all the answers

What is a common side effect of typical antipsychotics related to their impact on the brain?

Parkinsonian symptoms Signup and view all the answers

Which area of the brain does haloperidol primarily target with its mechanism of action?

Basal ganglia Signup and view all the answers

What is the main difference between typical and atypical antipsychotics in terms of efficacy?

Atypical antipsychotics are more effective for positive symptoms. Signup and view all the answers

Which symptom of schizophrenia is NOT effectively treated by atypical antipsychotics?

Aggression Signup and view all the answers

What is the potential consequence of abruptly stopping certain medications like G,M,S?

Development of GI distress, movement problems, and sleep disturbances Signup and view all the answers

Which medication combination should be avoided due to the risk of serotonin syndrome?

SSRIs with MAOIs Signup and view all the answers

What is a key side effect associated with certain medications mentioned in the text?

Nausea and vomiting Signup and view all the answers

Why is it important to monitor the suicidal client, especially during improved mood and increased energy levels?

To prevent self-harm or suicide attempts Signup and view all the answers

When should medications be taken to reduce the risk of insomnia?

In the morning Signup and view all the answers

What is a potential serious condition that might develop if a client experiences priapism?

Tissue damage in the penis Signup and view all the answers

What is a contraindication for using benzodiazepines?

Acute narrow-angle glaucoma Signup and view all the answers

Which benzodiazepine is indicated for panic, generalized anxiety, phobias, and social anxiety?

Clonazepam (Klonopin) Signup and view all the answers

What side effect is NOT commonly associated with benzodiazepines?

Tachycardia Signup and view all the answers

What is a key nursing intervention for clients taking benzodiazepines?

Monitor for visual disturbances Signup and view all the answers

Which neurotransmitter's action is promoted by barbiturates and sedative-hypnotics?

GABA Signup and view all the answers

What is the primary use of barbiturates and sedative-hypnotics?

Short-term treatment of insomnia and anxiety Signup and view all the answers

What is a behavior-specific sign to look out for in a person exhibiting suicidal behavior?

Visiting or calling people to say goodbye Signup and view all the answers

What is recommended to avoid when dealing with a client showing possible suicidal tendencies?

Taking the client's side in family disputes Signup and view all the answers

Which action should be taken if a suicidal client is in possession of harmful objects like razors or ropes?

Removing the harmful objects without causing harm to oneself or the client Signup and view all the answers

What can increased anxiety and insomnia in a client indicate?

Impending suicide attempt Signup and view all the answers

What can withdrawing from activities, isolating from family and friends, and giving away prized possessions be signs of?

Suicidal behavior Signup and view all the answers

Why is it important to avoid excess support when dealing with someone exhibiting suicidal behavior?

To promote feelings of abandonment Signup and view all the answers

Study Notes

Antipsychotics

Improve thought process and behavior in clients with psychotic symptoms, especially those with schizophrenia
Block dopamine receptors in the basal ganglia of the brain, inhibiting transmission and reducing psychotic symptoms
Indicated for acute and chronic psychosis

Typical Antipsychotics (First Generation)

Developed between 1950 and 1990
More effective for positive symptoms of schizophrenia, such as:
- Hallucinations
- Aggression
- Delusions
Also block the chemoreceptor trigger zone and vomiting center in the brain, producing an antiemetic effect

Atypical Antipsychotics (Second Generation)

Developed from 1990 onwards
More effective for negative symptoms of schizophrenia, such as:
- Withdrawal
- Apathy
- Alogia (inability to speak)

Electroconvulsive Therapy (ECT)

Administered with muscle relaxants and short-acting anesthesia to prevent fractures
Most common anesthetic agents: methohexital and propofol
100% oxygen by mask via positive pressure is administered throughout the procedure
Bilateral ECT: most common, most effective, and most cognitive dysfunction
Unilateral ECT: less cognitive effect, may be clinically less effective

Nursing Interventions

Monitor VS, weight, and potential for discontinuation syndrome
Educate client about potential for serotonin syndrome
Report any visual changes to physician
Monitor for suicidal behavior, especially during improved mood and increased energy levels

Benzodiazepines

Contraindicated in clients with acute narrow-angle glaucoma
Used cautiously in children and older adults
Abrupt withdrawal can be potentially life-threatening and should be done under medical supervision
Side effects include:
- Daytime sedation
- Dizziness
- Drowsiness
- Poor coordination
- Hypotension
- Constipation
- Urinary incontinence
- Impaired memory

Barbiturates and Sedative-Hypnotics

Depress the reticular activating system by promoting the inhibitory synaptic action of GABA
Used for short-term treatment of insomnia or for sedation to relieve anxiety, tension, and apprehension

Suicidal Behavior Disorder

Behavioral signs to look out for:
- Increased use of alcohol or drugs
- Looking for a way to kill themselves
- Acting recklessly
- Withdrawing from activities
- Isolating from family and friends
- Sleeping too much or too little
- Visiting or calling people to say goodbye
- Giving away prized possessions
- Aggression
Nursing interventions:
- Give client a sense of control
- Assist with problem-solving and decision-making
- Develop and use a suicidal contract
- Avoid excess support, as it encourages dependency and eventual feelings of abandonment

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Description

Test your knowledge on medication discontinuation syndrome and serotonin syndrome, characterized by potential visual changes, GI distress, movement problems, sleep disturbances, elevated temperature, elevated CPK, and muscle rigidity. Learn about the risks involved with abrupt medication changes and combining SSRIs with MAOIs.