1. Cerebrovascular accident or stroke is a common cause of death Risk factors are high blood pressure, high cholesterol diet, smoking and alcohol abuse, genetics, specific race (African-American) and sedentary lifestyle.
MOST ACCURATE ANSWER WHEN DEALING WITH THIS TYPE OF PATIENT IS
ADMINISTRATION OF PRESCRIBED ANTI-HYPERTENSIVE DRUGS.
Also, REPORT PATIENT WITH SIGN OF RIGID FLEXION OF ARMS AT THE ELBOWS AS THAT
SIGNIFIES ⚠️DECEREBRATE (INDICATOR OF DETERIORATING OF LEVEL OF
CONCIOUSNESS).
2. Hydrocephalus is a condition wherein there is an abnormal fluid collection of
cerebrospinal fluid inside the brain. Sign and symptoms are; INCREASED IN
INTRACRANIAL PRESSURE (KEYWORD IS HIGH PITCHED CRY), HEAD CIRCUMFERENCE IS
LARGER THAN CHEST CIRCUMFERENCE, SUNSET EYES AND MACEWEN SIGN (CRACKED
POT SOUND DURING PERCUSSION).
3. Febrile seizure is an alarming situation for pediatric client between 6months to 6 years
old. The main cause is still unknown up to now.
IF THIS QUESTION POPS IN YOUR ACTUAL EXAM DAY, JUST FOLLOW THE SAME
MANAGEMENT FOR SEIZURE SUCH AS PLACING THE CLIENT IN SIDE LYING POSITION,
RAISING SIDE RAILS UP, LOOSEN RESTRICTIVE CLOTHING AND GIVE ANTIPYRETICS
(PRIORITY MANAGEMENT).
4. Common anti-convulsant drugs are the following:
✅CARbamazepine (Tegretol) = Adverse effect is myelosuppression (Infection)
✅DEpakene (Valproic acid) = teratogenic
✅GAbapentin (Neurontin) = Maintenance drug for patient in ICU
✅LAmotrigine (Lamictal) = Drug of choice for trigeminal neuralgia
✅PHEnytoin (Dilantin) = FAVORITE DRUG SA EXAM
1) LAB VALUE = 10-20mcg/dL
2) Can cause hypotension
3) Can cause bleeding and infection
4) Can cause discoloration of the urine
5. TOpiramate (Topamax) = Drug of choice for migraine and bulimia nervosa. Side effect is
⚠️WEIGHT LOSS.
6. Levetiracetam (Keppra) = New generation anti-convulsant. side effect: DROWSINESS!
7. Children with sickle cell anemia are at risk for having ISCHEMIC STROKE. COMMON
MANIFESTATION IS SICKLE CELL CRISIS WITH SUDDEN-ONSET ARM WEAKNESS.
COMMON EXAM ANSWER!
8. Common anti-depressant medications are the following:
💊Tricyclic antidepressants
1) Pamelor (norTRIPTYLINE)
2) Elavil (amiTRIPTYLINE)
3) Anafranil (ClomiPRAMINE)
4) Tofranil (ImiPRAMINE)
Selective serotonin reuptake inhibitor
1) Prozac (FluoXETINE)
2) Zoloft (SerTRALINE)
3) Paxil (paroXETINE)
4) Escitalopram (Cipralex)
9. COMMON EXAM ANSWERS ABOUT SSRI
📝ALL DRUGS CAN CAUSE WEIGHT GAIN
📝ALL DRUGS CAN LEAD TO INSOMNIA
📝ALL DRUGS CAN LEAD TO SEXUAL DYSFUNCTION
📝AVOID ALCOHOL AND ANTI-HISTAMINES
10. Monoamine oxidase inhibitor (MAOI)
1) Parnate (tranylcypromine)
2) Nardil (Phenelzine)
3) Marplan (Isocarboxazid)
11. COMMON EXAM ANSWERS ABOUT MAOI
1) NO TO TYRAMINE RICH FOODS
2) NO TO ALCOHOL AND SMOKING
12. DO NOT EVER COMBINE ANY ANTI DEPRESSANTS!!! IT CAN LEAD TO A FATAL DISEASE
KNOWN AS SEROTONIN SYNDROME. MANIFESTATIONS ARE INCREASED ALL VITAL
SIGNS, MUSCLE RIGIDITY AND SEIZURE. MANAGEMENT IS ADMINISTRATION OF
MUSCLE RELAXANT (e.g. DANTROLENE SODIUM AND SUCCINYLCHOLINE.
(COMMON EXAM QUESTION!)
13. Level of anxiety are the following:
Mild: Increase learning and focus (BEST KAPAG MAG-EEXAM)
Moderate: Increase learning but no focus
Severe/panic: NO LEARNING AND FOCUS; NARROWING OF THE MIND PERCEPTION.
MANAGEMENTS ARE TO:
STAY WITH THE CLIENT, STAY CALM AND DO SIMPLE INSTRUCTIONS.
💊PHARMACOLOGICAL MANAGEMENT:
BENZODIAZEPINES ("pam")
☆Alprazolam
☆Midazolam
☆Diazepam
☆Lorazepam
🍷CHLORDIAZEPOXIDE (LIBRIUM) = USE FOR ALCOHOL WITHDRAWAL
14. BENZODIAZEPINE TOXICITY MEDICATION IS FLUMAZENIL (COMMON EXAM QUESTION!)
15. Tips to remember when handling patient with spinal cord injury accident:
✅Position the client on a firm surface
✅Use logrolling to move the client
✅Spine should be in neutral position at all times
✅Apply a cervical collar to immobilize the spine
16. Common mental health therapies in the exam are the following:
📚Milieu therapy = Changing one’s ok environment to increase mental clarity and to change
one’s perception in life.
🗣Cognitive behavioral therapy = A method in attempting to reconnect the thoughts to
execute appropriate action in a certain scenario.
17. Group therapy = for self-awareness. MOST COMMON BENEFICIARY FOR THIS
TREATMENT ARE PATIENTS WHO ARE ⚠️ALCOHOLICS.
18. Methylphenidate (Ritalin) is a CNS stimulant use for patient with attention deficit
hyperactive disorder (ADHD).
TIPS TO REMEMBER:
Side effects: INSOMNIA AND WEIGHT LOSS.
✅IF ONCE A DAY, GIVE THE MEDICINE BEFORE BREAKFAST.
✅IF TWICE A DAY, GIVE IT BEFORE BREAKFAST AND BEFORE
LUNCH.
CHECK THE PATIENT’S HEIGHT/WEIGHT AND VITAL SIGNS.
SIGN OF EFFECTIVENESS: IMPROVED SCHOOL PERFORMANCE
19. Tips to remember when handling unconscious client with history of car crash accident:
Place a cervical collar on the client (AUTOMATIC FOR CAR CRASH, SPINE SHOULD
BE HANDLED WITH CAUTION).
Remove the client from the car and place the client in a firm surface.
Assess the client’s pulse.
Check client’s level of consciousness by using GLASGOW COMA SCALE.
20. Head injury or concussion is a minor neurologic condition that involves a trauma due
to blunt force or an acceleration/deceleration motion (coup-countercoup).
21. COMMON SIGN AND SYMPTOMS ARE
Loss of consciousness
Headache
Amnesia (retrograde)
22. Patient with major depression is prone for having imbalance food intake because of
their low self-esteem. As a nurse, it is a must to include foods that are HIGH IN PROTEIN
AND CALORIES. Examples are vegetables, potatoes, fishes, lean meat and fruits.
23. Autism is a developmental disorder that involves problem in communication and
interaction. The disease usually starts at age 2, wherein there is an evidence of an infant
being mute when he/she cry. Best management for this deviation is to have a
STRUCTURED ROUTINE AND CONSISTENCY.
24. Bulimia nervosa is an example of an eating disorder common in teenagers and those
who are suffering from insecurities related to weight gain. Common findings include
BINGE EATING, PURGING AFTER EATING, IMPROPER DENTAL HEALTH AND CALLOUS
FORMATION OF THE KNUCKLES.
Management for this condition are the following: [BAM]
Be cautious to hidden foods underneath the bed (VERY COMMON)
Assess patient’s overall status such as vital signs and electrolyte imbalances
Monitor client’s post meal activity at least 1-2 hours after eating.
25. Tips to remember when administering lithium to patient with mania:
Level = 0.6 – 1.2 mEq/dL (1.5mEq still acceptable)
Increase urine output = at risk for DEHYDRATION
Toxicity effect: Coarse tremors, Kidney failure
Hand: Fine tremors is expected
Increase fluid intake: to fight off DEHYDRATION
Uu: Diarrhea (HANAPIN MO YUNG WORD NA STOMACH FLU)
Monitor sodium level and intake
note: credits po sa kay Angel16 🙏 na nagbigay ng informative nursing notes na'to..
#psychiatric_nursingnns
