Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Nursing Psych/<3

bipolar disorder, schizophrenia, drug abuse, depression, and cardiovascular

QuestionAnswer
Name the clot busters. TNKase, Streptase, Retavase, and Activase give within 6 hours of AMI onset
What are side effects of clot busters? bleeding, hypotension, allergic reaction
What are clot busters used to treat? AMI, PE, DVT
Name the clot busters. TNKase, Streptase, Retavase, and Activase give within 6 hours of AMI onset
What is unstable angina? unpredictible CP, worsening pattern that occurs at rest, can progress to MI or return to stable lesion
What are side effects of clot busters? bleeding, hypotension, allergic reaction
What are side effects of clot busters? bleeding, hypotension, allergic reaction
What are clot busters used to treat? AMI, PE, DVT
What are the contraindications for clot busters? recent CVA, cerebral neoplasm, active bleeding, severe HTN, UC, anticoagulant therapy, advanced age, recent CPR
What are clot busters used to treat? AMI, PE, DVT
What are the s/s of a MI? sudden prolonged severe CP, radiating, not relieved by rest or nitrates, diaphoresis, n/v, decreased CO, ST elevation
What is unstable angina? unpredictible CP, worsening pattern that occurs at rest, can progress to MI or return to stable lesion
What are the contraindications for clot busters? recent CVA, cerebral neoplasm, active bleeding, severe HTN, UC, anticoagulant therapy, advanced age, recent CPR
What individuals will have different pain with a MI/ACS? DM, women, HTN, elderly
How long should the pt. wear oxygen after an MI? 24-48 hours
What is unstable angina? unpredictible CP, worsening pattern that occurs at rest, can progress to MI or return to stable lesion
What individuals will have different pain with a MI/ACS? DM, women, HTN, elderly
How long should the pt. wear oxygen after an MI? 24-48 hours
What are the s/s of a MI? sudden prolonged severe CP, radiating, not relieved by rest or nitrates, diaphoresis, n/v, decreased CO, ST elevation
Aspirin thrombus prevention before, during, or after a MI, 81 mg x 4= 324 mg, s/e: GI upset, bleeding, tinnitus
Morphine Sulfate decreases myocardial O2 demands and relieves pain, titrate to pain, s/e: respiratory depression, sedation; antidote: narcan
Magnesium IV given for torsades de pointes
How long should the pt. wear oxygen after an MI? 24-48 hours
Calcium Chloride given for acute hyperkalemia or hypocalcemia
Aspirin thrombus prevention before, during, or after a MI, 81 mg x 4= 324 mg, s/e: GI upset, bleeding, tinnitus
Sodium Bicarbonate given for metabolic acidosis with prolonged CPR
Magnesium IV given for torsades de pointes
Angiogram PCI, images of blood vessels using contrast, complications: damage to arterial wall, PLT aggregation, MI, death, stent failure
Calcium Chloride given for acute hyperkalemia or hypocalcemia
Chantix (varenicline) for smoking cessation, PO, after meals, x 12 weeks, can smoke while on it
stent placement wire mesh treats abrupt or threatened closure of vessel, antiplatelet angents given, complications same as angiogram
Sodium Bicarbonate given for metabolic acidosis with prolonged CPR
PTCA (percutaneous transluminal coronary angioplasty) balloon catheter inflated to enlarge diameter of vessel, same complications as angiogram
Questran (cholestyramine) bile acid sequestrant, ACHS, gritty powder mixed in 120-240 mL of juice, s/e: GI distress, may interfere with coumadin (increase bleeding), reduced absorption of Vit ADEK, monitor PT, other meds 1 hr before or 6 hr after
Angiogram PCI, images of blood vessels using contrast, complications: damage to arterial wall, PLT aggregation, MI, death, stent failure
Questran (cholestyramine) bile acid sequestrant, ACHS, gritty powder mixed in 120-240 mL of juice, s/e: GI distress, may interfere with coumadin (increase bleeding), reduced absorption of Vit ADEK, monitor PT, other meds 1 hr before or 6 hr after
Chantix (varenicline) for smoking cessation, PO, after meals, x 12 weeks, can smoke while on it
Integrilin (eptifibatide) prevents aggregation of clotting factors, short term prevention of ischemic complications of AMI and during PCI, IVPB in combo with ASA and low dose heparin; tx time: 24-72 hrs, super aspirin, expensive
PTCA (percutaneous transluminal coronary angioplasty) balloon catheter inflated to enlarge diameter of vessel, same complications as angiogram
Coronary Artery Bypass Graft MVD or severe occlusions that cannot be corrected with PCI, leg vein used to reroute blood flow around the coronary occlusion and restore blood flow to the heart tissue
stent placement wire mesh treats abrupt or threatened closure of vessel, antiplatelet angents given, complications same as angiogram
Cardiac Tamponade accumulation of blood, pus, or fluid in pericardial sac (120-150 mL), heart compressed,
Questran (cholestyramine) bile acid sequestrant, ACHS, gritty powder mixed in 120-240 mL of juice, s/e: GI distress, may interfere with coumadin (increase bleeding), reduced absorption of Vit ADEK, monitor PT, other meds 1 hr before or 6 hr after
Integrilin (eptifibatide) prevents aggregation of clotting factors, short term prevention of ischemic complications of AMI and during PCI, IVPB in combo with ASA and low dose heparin; tx time: 24-72 hrs, super aspirin, expensive
Coronary Artery Bypass Graft MVD or severe occlusions that cannot be corrected with PCI, leg vein used to reroute blood flow around the coronary occlusion and restore blood flow to the heart tissue
Pericarditis 2-4 days after MI, swollen heart muscle rubs agains pericardial surface and causes it to lose it's lubricating fluid=friction rub,pt will have pain worsens when supine, fever, palpitations, SOB; TX: abx and antiinflammatories
Cardiac Tamponade accumulation of blood, pus, or fluid in pericardial sac (120-150 mL), heart compressed, leads to cardiac failure and cardiogenic shock, tx: pericardiocentesis
Cardiogenic Shock failure of heart to pump effectively (decreased CO and tissue perfusion), EF severely decreased, death most likely
Epinephrine (adrenaline) increased BP, HR, and CO; tx cardiac arrest, IV/IO push, ETT in 10 mL of NS, S/E: tachycardia, HTN, toxicity with CRI
Amiodarone (cordarone) decreases excitability (ectopic foci); tx: pvcs, vt, a.fib/flutter; Emergency: IV/IO push; maintenance with drip, s/e: decreased HR and BP, photophobia, skin discoloration
Digoxin (lanoxin) decreased HR, increased ventricle contraction, increased CO; tx: CHF, a.fib/flutter; dose: IVP slow diluted; toxicity: halos, yellow vision, AMS, n/v; MUST HAVE NORMAL K AND MG LEVELS!!!!
Digoxin serum level 0.5-2.0
Lidocaine (xylocaine) decreased excitability, suppresses numbs ectopic beats ONLY IN THE VENTRICLE; tx: pvcs, vt, vf; IV/IO push then drip, ETT in 10 ml NS, s/e: neurotoxicity
Adenocard (adenosine) decreased conduction through AV node (stops heart); tx: svt; short half life; s/e: asystole, CP, flushing
Atropine Sulfate stimulates SA node (atrium), tx: bradycardia (symptomatic); IV/IO push, ETT in 10 mL NS, s/e: anticholinergic, increased hr
Cardizem (diltiazem) calcium channel blocker, decreased AV node conduciton, tx: svt, a.fib/flutter; iv bolus then drip; s/e: hypotension, myocardial depression
Zelta (ezetimibe) decreases cholesterol absorption/fat in GI tract; QD without regard to meals; s/e myalgias, arthralgias, diarrhea, assess LFT
Statin Drugs-Atorvastatin (Lipitor), lovastatin (mevacor), simvastatin (zocor), rosuvastatin (crestor) increases HDL, decreases LDL, PO qHS, no GF juice, s/e: increased LFT, rhabdomyalysis; report muscle pain, LFT q3-6 months
Lovaza (fish oil/omega 3 acid ethyl esters) lowers cholesterol, take at night, s/e: burping, flu symptoms, GI distress, change in taste; can not take if allergic to fish
Nicotinic Acid (Niacin, vitamin B12) lowers lipids, give with food, MOST PEOPLE DO NOT TOLERATE, s/e: GI distress, facial flushing, increased LFT
Gemfibrozil (lopid) lowers lipids, take 30 min before meals, s/e: increased bleeding, GI distress, not take at same time as anticoagulants
fenofibrate (tricor) lowers lipids, take with meals, s/e : increased bleeding, GI distress; do not take with anticoagulants
Stable Angina predictable intermittent CP, only 3-5 minutes, no pain at rest, relieved by nitrates, pain is never sharp or stabbing and never changes with position changes
Nitroglycerin (NTG) potent vasodilator, s/e: hypotension, HA; check BP, light sensitive, replace tabs q3-5 months
ACE inhibitors lowers bp, decreases vascular resistance; tx: CHF, protects kidneys
CCB lowers bp, decreases sa/av conduction, vascular relaxation; tx: angina, atrial tachydysrhythmias, pvd (#1 drug for pvd)
BB lowers hr,bp, and heart's o2 need; tx: angina, MI, irregular hr, tremors, chf
dopamine controls movements decreased levels= resting muscle tremors increased levels= schizophrenia cocaine and amphetamines increase levels
s/s of addiction dilated or constricted pupils, abnormal vs, track marks, tremors, etoh on breath, drug paraphenalia, bal, uds
What do antiepileptics do? decrease mania and stabilizes mood
What are the s/e of antiepileptics? rash, decreased wbc, hepatic/renal damage monitor therapeutic serum levels
Antiepileptic drugs Depakene, Depakote, Tegretol, Lamictal
Lithium Carbonate mood stabilizer for acute and recurrent tx of BPD, 7-14 days before effective, taper to d/c, BID or TID dosing, expected s/e: nausea, thirst, polyuria, fine hand tremors; other s/ewt gain, hypothyroidism; ci: renal, cv, thyroid
Serum lithium levels 0.5-1.5 draw levels 12 hours after last dose
What are the s/s of toxicity of lithium? diarrhea, vomiting, drowsiness, decreased coordination, convulsions, muscle weakness, coma, death
Bipolar disorder swings in mood, energy, and ability to fx rapid cycling: mania, normal activity, depression just dont know the cause
cyclothymia hypomania alternating with minor depression
Bipolar II Disorder hypomania alternating with major depression
Bipolar I Disorder mania alternating with major depression
Mania unstable elevated mood with delusions, poor judgement, and impaired reality does not sleep or eat hospitalization if unsafe
Electroconvulsive therapy (ECT) shock therapy, electrical current to brain = seizures; tx: suicidal, severe depression, bpd; used when meds not successful; need consent, give anticholinergic with muscle relaxer, crash cart; complaints sfter: HA, muscle soreness, nausea; lie on side, vs
Serotonin Syndrome excessive serotonin levels s/e: AMS, agitation, increased hr, htn, muscle rigidity, fever, sweating, tremor untreated: cv collapse, death
tyramine biproduct of tyrosine in processed foods need to decrease in diet with maois or htn, cva, or htn crisis can occur
MAOIs increase serotonin, dopamine, and tyramine; tx: depression, phobias, anxiety; go to er if severe ha, bp x 6 wks when starting drug; not compatible with most drugs NARDIL, PARNATE, MARPLAN
TCAs increase serotonin ELAVIL, PAMELOR, TOFRANIL start low and go slow, no alcohol! s/e anticholinergic effects, sedation, lethal in OD toxic effects: avb, increased hr, MI ci: cv hx, glaucoma, pregnancy
SNRIs increase serotonin tx: depression, anxiety, ocd, fibromyalgia CYMBALTA, EFFEXOR, PRISTIQ s/e: insomnia, suicidal thoughts, sexual dysfx
Atypical (Novel) antidepressants increase serotonin tx: depression, smoking cessation WELLBUTRIN, ZYBAN, REMERON, SERZONE s/e: sedation, increased suicidal ideations
SSRIs increases serotonin=mood tx: depression, anxiety, ocd PROZAC, ZOLOFT, PAXIL, CELEXA, LEXAPRO faster onset (max 2 wks) less dangerous c/ od s/e: drowsiness, insomnia, sexual dysfx, gi symptoms early, ha effective in 2-4 wks
Clozpine (clozaril) dopamine and serotonin antagonist (decreases) agranulocytosis (bone marrow supression) risk-bleeding, infection weekly cbc, w/draw med if agranulocytosis occurs one week rx at a time
2nd Generation Antipsychotics (atypical) dopamine and serotonin angtagonist (decreases) CLOZAPINE, RISPERDAL, GEODON, SEROQUEL, ZYPREXA, ABILIFY tx: positive and negative sx s/e: decreased eps, decreased relapse, sedation, increased chance of dm (increased bs) 1st line drugs for schizophren
Congentin (benzotropine) anticholinergic, antiparkinson 1st generation antipsychotic tx: eps tx/prevention po, im, iv (rare) s/e: r/t everything dries up, photosensitivity, orthostatic hypotension
Tardive Dyskinesia with long term therapy IRREVERSIBLE, may decrease w/ dosage reduction INVOLUNTARY TWISTING/WRITHING MOVEMENTS OF TONGUE AND FACE, LIPS, LIMBS, TOES, FINGERS, AND TRUNK prevention: decrease effective dose of antipsychotic + congentin, AIMS scale
Clozpine (clozaril) dopamine and serotonin antagonist (decreases) agranulocytosis (bone marrow supression) risk-bleeding, infection weekly cbc, w/draw med if agranulocytosis occurs one week rx at a time
2nd Generation Antipsychotics (atypical) dopamine and serotonin angtagonist (decreases) CLOZAPINE, RISPERDAL, GEODON, SEROQUEL, ZYPREXA, ABILIFY tx: positive and negative sx s/e: decreased eps, decreased relapse, sedation, increased chance of dm (increased bs) 1st line drugs for schizophren
Clozpine (clozaril) dopamine and serotonin antagonist (decreases) agranulocytosis (bone marrow supression) risk-bleeding, infection weekly cbc, w/draw med if agranulocytosis occurs one week rx at a time
2nd Generation Antipsychotics (atypical) dopamine and serotonin angtagonist (decreases) CLOZAPINE, RISPERDAL, GEODON, SEROQUEL, ZYPREXA, ABILIFY tx: positive and negative sx s/e: decreased eps, decreased relapse, sedation, increased chance of dm (increased bs) 1st line drugs for schizophren
Congentin (benzotropine) anticholinergic, antiparkinson 1st generation antipsychotic tx: eps tx/prevention po, im, iv (rare) s/e: r/t everything dries up, photosensitivity, orthostatic hypotension
Tardive Dyskinesia with long term therapy IRREVERSIBLE, may decrease w/ dosage reduction INVOLUNTARY TWISTING/WRITHING MOVEMENTS OF TONGUE AND FACE, LIPS, LIMBS, TOES, FINGERS, AND TRUNK prevention: decrease effective dose of antipsychotic + congentin, AIMS scale
Congentin (benzotropine) anticholinergic, antiparkinson 1st generation antipsychotic tx: eps tx/prevention po, im, iv (rare) s/e: r/t everything dries up, photosensitivity, orthostatic hypotension
Akathisia uncontrolled urge to be in constant motion reversible 1st 6 wks of tx give low does of bb, benzos, anticholinergics (congentin)
Parkinsonism bradykinesia, mask-like face, drooling, tremor, rigidity, shuffling gait, stooped posture reversible develops 1st month of therapy give low dose with congenting or benadryl
Tardive Dyskinesia with long term therapy IRREVERSIBLE, may decrease w/ dosage reduction INVOLUNTARY TWISTING/WRITHING MOVEMENTS OF TONGUE AND FACE, LIPS, LIMBS, TOES, FINGERS, AND TRUNK prevention: decrease effective dose of antipsychotic + congentin, AIMS scale
Acute Dystonia min/hrs/days of 1st dose severe muscle spasms/cramping of tongue, neck, back, face, eye deviation also possible with phenergan & reglan immediate reversal with iv or im congentin or benadryl
Akathisia uncontrolled urge to be in constant motion reversible 1st 6 wks of tx give low does of bb, benzos, anticholinergics (congentin)
Flat Affect negative sx no facial expression/blank look
Parkinsonism bradykinesia, mask-like face, drooling, tremor, rigidity, shuffling gait, stooped posture reversible develops 1st month of therapy give low dose with congenting or benadryl
Inappropriate Affect negative sx emotional response does not match situation
Acute Dystonia min/hrs/days of 1st dose severe muscle spasms/cramping of tongue, neck, back, face, eye deviation also possible with phenergan & reglan immediate reversal with iv or im congentin or benadryl
Bizarre Affect negative sx grimacing, giggling, mumbling to oneself
1st Generation Antipsychotics (conventional) decrease dopamine levels HALDOL, PROLIXIN, THORAZINE, LOXITANE tx: positive sx, relapse prevention, acute agitation nasty s/e: eps, full effects 2-4 wks/months, intial effects in 2-4 days
Stupor positive sx motionless for long periods of time may appear to be in coma
Flat Affect negative sx no facial expression/blank look
Wavy Flexibility positive sx excessive maintenance of abnormal posture
Inappropriate Affect negative sx emotional response does not match situation
Automatic Obedience positive sx follows simple commands robot-like fashion
Bizarre Affect negative sx grimacing, giggling, mumbling to oneself
Stereotyped Behaviors positive sx motor patterns that had meaning now lack purpose folding towels-mill worker
Stupor positive sx motionless for long periods of time may appear to be in coma
Extreme Motor Agitation positive sx increased physical behavior risks: exhaustion, collapse, death constant running
Wavy Flexibility positive sx excessive maintenance of abnormal posture
Derealization positive sx false perception environment has changed going home, asking where am i?
Automatic Obedience positive sx follows simple commands robot-like fashion
Depersonalization personal boundary difficulties lost identity, self different or unreal fingers are snakes, arms rotting wood
Stereotyped Behaviors positive sx motor patterns that had meaning now lack purpose folding towels-mill worker
Illusion something is there but what they describe isn't what is there
Extreme Motor Agitation positive sx increased physical behavior risks: exhaustion, collapse, death constant running
Command Hallucinations can be dangerous signify psychiatric emergency
Derealization positive sx false perception environment has changed going home, asking where am i?
Auditory Hallucinations turning head frequent blinking grimacing responding to unseen others
Depersonalization personal boundary difficulties lost identity, self different or unreal fingers are snakes, arms rotting wood
Benzodiazepines for withdrawal delerium LIBRIUM, VALIUM, SERAX, ATIVAN po tapered over 5-7 days anticonvulsant effects,sedates
Illusion something is there but what they describe isn't what is there
Vivitrol, ReVia (naltrexone) im q month decrease alcohol cravings, helps abstain from alcohol
Auditory Hallucinations turning head frequent blinking grimacing responding to unseen others
Command Hallucinations can be dangerous signify psychiatric emergency
Benzodiazepines for withdrawal delerium LIBRIUM, VALIUM, SERAX, ATIVAN po tapered over 5-7 days anticonvulsant effects,sedates
Auditory Hallucinations turning head frequent blinking grimacing responding to unseen others
Vivitrol, ReVia (naltrexone) im q month decrease alcohol cravings, helps abstain from alcohol
Benzodiazepines for withdrawal delerium LIBRIUM, VALIUM, SERAX, ATIVAN po tapered over 5-7 days anticonvulsant effects,sedates
s/s of cns stimulant addiction
Vivitrol, ReVia (naltrexone) im q month decrease alcohol cravings, helps abstain from alcohol
s/s of cns stimulant intoxication crack cocaine, amphetamines dilation of pupils, dry mouth, increased motor activity, increased bp, insomnia, hallucinations, paranoia
cns stimulant od resp depression, hyperpyrexia, mi, coma, death
opiate intoxication opium, morphine, heroin, codeine, fentanyl, methadone, demerol, dilaudid everything slows down, constricted pupils, impaired judgement and memory, slurred speech abcs, supportive, narcan ivp
marijuana (cannabis sativa) smoked, ingested po s/s: euphoria, detachment, relaxation, talkativeness, slowed perception of time, increased sensitivity to stimuli, mellows med indications (13 states) chemo induced nausea, decrease iop, increase appetite
Hallucinogens LSD, peyote, PCP po, sniffed, smoked intoxication s/s: same as stimulant + synesthesia (speeds everything up) od: psychosis, brain damage, death, hyperthermia tx: abcs, low stimuli, speak slowly in low voice, valium, haldol
inhalants intoxication: excitation followed by drowsiness, disinhibition, staggering, light-headedness, agitation, euphoria od- damage to cns tx support affected systems
amphetamines s/e euphoria, increased energy, increased self-confidence, increase sociability, increased temp, hf, rf, dehydration
GHB (rohypnol) benzodiazepine ruffie mixed easily in drinks (colorless, odorless, tasteless) unconscious in min + retrograde amnesia
Hallucinations positive sx sensory perceptions where no external stimuli exists auditory, visual, olfactory (smell), gustatory (taste), tactile (feel)
Word Salad positive sx jumble of words meaningless to listener and speaker (neologisms, similar to associative looseness) i am fine, apple pie, no sale, furniture stor, take it slow, cellar door
Clang Association positive sx meaningless rhyming of words, forceful manner rhyming more important than content lil wayne
Echopraxia positive sx mimicking anothers movements catatonic state
Echolalia positive sx repitition of anothers words catatonic states rainman
Neologism positive sx word that a person makes up that has a special meaning to them children and creative writers = disruption in thought processes norks?
Associative looseness positive sx threads linking thoughts together are absent thinking illogical, haphazard, confused can't go to the zoo, no money, oh... i have a hat, these rumors make no sense, man... what's the problem
Concrete Thinking positive sx overemphasis on specific details literal, abstract thinking missing, normal for children What brings you to the er? ambulance
Delusions positive sx false beliefs that cannot be corrected by reasoning, loosely organized and bizarre persecutory (out to get me) grandoise (i am cleopatra) religious, hypochondrial, controlled leads to increased anxiety, thoughts w/drawn, broadcasted, inse
Serotonin regulates sleep and emotional states decreased levels= depression, anxiety increased levels c/ exercise and balanced diet
Alcohol W/drawal signs of delirium develop hrs after last drink hallucinations and illusions common peak @24-48 hrs, rapidly and dramatically disappear
Delirium disturbance of cognition, manifested by confusion, excitement, disorientation, and clouding of conciousness etoh induced delirium tremens (DTs) lasts 3-6 days
Anticonvulsants for DTs w/ drawal delirium med phenoobarbital mg sulfate
Antabuse (disulfiram) motivated clients/voluntary alcoholics po, qday unpleasant reaction when mixed with etoh 30 min. after drink in system 2 weeks after last dose
CNS depressants etoh, benzos, barbituatates s/s: slows down (sedation, ataxia, vomiting, resp depression, hypotension, rf, shock, coma, death tx abcs, gastric lavage, dialysis, romazicon, ivp reverses benzos
Created by: 1000080201