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ATI feedback 2016

1- Elderly pt sign of abuse?

R-Bruissed chin 

2- computation 

R-15 

3-Amitiphiline? side effects? Ch 20- 180 

Amitiphiline is a Tricyclic antidepressants  

S.E: 
Drowsiness​, ​dizziness​, ​dry mouth​, blurred vision, ​constipation​, ​weight gain​, or
trouble urinating may occur. If any of these effects persist or worsen, notify your doctor
or pharmacist promptly. To reduce the risk of ​dizziness​ and ​lightheadedness​, get up
slowly when rising from a sitting or lying position
4- Heroin : Side effect? ch 17 p 150
The effects of heroin abuse will differ from person to person, depending upon the length
of abuse, amount of heroin used, the presence of other substances, and individual
makeup. Severity of symptoms tend to get worse the longer the drug is abused. The most
common effects of heroin addiction may include:
∙ Liver disease
∙ Skin disease and abscesses around injection sites
∙ Infections of the valves and lining of the heart
∙ HIV or Hepatitis B and C
∙ Chronic pneumonia
∙ Clouded mental functioning
∙ Collapsed, scarred veins
∙ Blood clots, leading to stroke, pulmonary embolism, and heart attack
∙ Kidney disease
∙ Risks of contracting chronic illnesses
∙ Risks for blood-borne pathogens
∙ Septicemia
∙ Respiratory depression
∙ Seizures
∙ Overdose
∙ Slurred speach, impaired memory, pupilary changes, and decreases respirations
and level of consciouseness, with can cause death.
 ∙ psychological changes, includoing impaired judgment or social fontioning
∙ An antidote is maloxone (narcan) relieve toxicitysymptoms tend to get worse the
longer the drug is abused. The most common effects of heroin addiction may
include

Withdrawal from heroin can be an unpleasant experience .Some effects of withdrawal

include:
Yawning,insomnia-rhinirheanausea and vomiting-muscle aches -fever lacrimation-
irritability-diaphoresis-cramp and diarrhea. withdrawal is treated by Methadone

5,TSH level: ?
TSH levels for premature birth (28​ ​36 weeks)
∙ 0.7​ ​27 mIU/L
TSH levels for children
∙ Birth to 4 days: 1​ ​39 mIU/L
∙ 2​ ​20 weeks: 1.7​ ​9.1 mIU/L
∙ 21 weeks to 20 years: 0.7​ ​64 mIU/L
TSH levels for adults
∙ 21​ 5​ 4 years: 0.4​ 4​ .2 mIU/L
∙ 55​ 8​ 7 years: 0.5​ 8​ .9 mIU/L
TSH levels during pregnancy
∙ First trimester: 0.3​ ​4.5 mIU/L
∙ Second trimester: 0.3​ ​4.6 mIU/L
∙ Third trimester: 0.8​ ​5.2 mIU/L
Small variations in results can occur depending on the laboratory and its methods used, as
well as the time of day your blood was taken.
6- Creatinine level?due toxicity liver
Elevated ​creatinine​ level signifies impaired kidney function or kidney disease. As the
kidneys become impaired for any reason, the ​creatinine​ level in the blood will rise due to
poor clearance of ​creatinine​ by the kidneys. Abnormally ​high​ levels of ​creatinine​ thus
warn of possible malfunction or failure of the kidneys.
Abnormally ​high​ levels of ​creatinine​ may indicate kidney damage or chronic kidney
disease. Functional damage to the kidneys can be due to a serious infection or low blood
flow to the kidneys. Reduced blood flow or low blood pressure can be a result of heart
failure, artery disease or severe dehydration.
7-Isolate pt in seclusion room:
This study compares the attitudes of nonsecluded patients hospitalized on psychiatric
units with either isolated or visible seclusion rooms. It was found that there were minimal
differences between units. Patients at the hospital with visible seclusion rooms more
often indicate that patients are often cured in such rooms, in contrast to the patients on the
other unit who endorsed more stereotypical perceptions of the quiet room.
8-Nalaxone
Naloxone​ blocks or reverses the effects of opioid medication, including extreme
drowsiness, slowed breathing, or loss of consciousness. ... ​Naloxone​ is used to treat a
narcotic overdose in an emergency situation. ... Drinking alcohol can increase certain side
effects of ​naloxone
9-occupational therapy?
Occupational therapy​ (OT) treatment focuses on helping people with a physical, sensory,
or cognitive disability be as independent as possible in all areas of ...
10- Dementia clothes?
Helping someone with ​dementia​ choose what to ​wear​ is an important role. .... It may help
to look for ​clothes​ that are ​easy​ to put on and take off, such as ​clothes​ .
11-Dissulfram( antabuse) A.E.?
Used for alcohol abstinence...(Naltrexone(revia), acomprosate (compra))
SIDE EFFECTS​: Drowsiness, tiredness, headache, acne, and metallic/garlic-like taste in
the mouth may occur as your body gets used to the medication. If any of these ​effects
persist or worsen, tell your doctor or pharmacist promptly
12- Bulimia?
Explores why women in general are more prone to develop ​bulimia ​than men
and which women in particular have a higher risk of becoming bulimic. Risk factors for
bulimia ​are discussed in terms of sociocultural variables, such as the central role of
beauty
13- Anorexia?
Anorexia Pt always under weight- ( less 85 %) age 18= cathexia- hair loss-
cyanosis of extremity-Lanugo- anxiety and depression.
14-bulimia signs?
Dental erosion / caries- Electrolyte imbalence. enlarge parotid glande.
15-SSRI?
Selective serotonin reuptake inhibitors​ (​SSRIs)​ , widely prescribed ... Half-lives for ​SSRIs
are variable, but most have a half-​life​ of 20 to 24 hours. ... Some recommend a 5-week
"wash-out" ​period​ for fluoxetine prior to initiation of an MAOI. ... any signs or
symptoms and 32% had a minor, self-limiting ​reaction

16- 4 pt restraints?
Four​-​point​ restraints may be required for patients with psychiatric illnesses or altered
mental status who become violent and dangerous in the emergency department. ...
Professionals must understand the indications and contraindications for the use of
physical restraints.
ROM every 2 hours.
17- Alcohol initial stage?
Tremor.....
18-Maniac?
Can not stop talking for days.
19- Herbal contraidicated to SSRI?
R_St john wort.
20-4 clients pririotizing....... most:
R-Bipolar pacing walking in the hallway.
21- 4 clients pririotizing....... most:
R- Hearing command hallucination.
22- suppresion:
23-Risk for physical abuse?
younger than 3 years old: preschooler
24-Borderline personality disorder?
R-Spliting behaviors-manupulations- inpulsiveness and fear of abandonnement.-
Often try self injury and can be suicide.
25- Dementia?
R- Put Bed alarm
26-Somatic clinical manifestation?
When somatic symptom disorder accompanies another medical disorder, patients
overrespond to the implications of the medical disorder; for example, patients who have
had complete physical recovery from an uncomplicated MI may continue to behave as
invalids or constantly worry about having another MI.
Somatic symptom disorder and related disorders are characterized by persistent physical
symptoms that are associated with excessive or maladaptive thoughts, feelings, and
behaviors in response to these symptoms and associated health concerns. These disorders
are distressing and often impair social, occupational, academic, or other aspects of
functioning. They include

Conversion disorder
Factitious disorders

Illness anxiety disorder

Psychological factors affecting other medical conditions

Somatic symptom disorder

Somatic symptom disorder and illness anxiety disorder are the most common.

27- confidentiality?
HIPPA
28-Pt ask how going to pay medication bills?
R- Social worker.
29-Akathisia,Side Efect?
R-state of agitation, distress, and restlessness that is an occasional side-effect of
antipsychotic and antidepressant drug
30-Amphetamine manifestation?
R- Tachicardia.
31-calculation?
4ml/5ml=0.8ml
32-Client taking clozapine for psochotic disorder what to monitor weekly?
R-WBC
33-serotonin syndrom? expection?
R-Fever
34-Bupropion?
R- Seizure
35- college student...?
R-sex natural condom
36-SSRI Side effects?
R-Tremors-diaphoresis-fatigue-drowsiness=weight gain-sexual disfunction- headach.
37-Patient with 4 points restraint?
R- perform circulation check every 15 minutes.
38-Alcohol withdwal side effects?
R-tachicardia- Hypertension- sweating and hand tremors,
39-Depress Pt?
R-Reduce environmrntal stimuli.
40-Medication for Dementia Patient?
R- Aricept.
41- Therapeutic communication?
R- Encourage open end question..