NR 607 Week 8 Final Exam Practice Questions & Answers

-The person in question may have the right to appear at their hearing w counsel and present evidence to dispute the case -The max length of inpatient commitment varies by state. -Outpatient commitment/assisted outpatient treatment (AOT)= may consist of supported housing, intensive case management, meds, and frequent therapy --Tx may last 6- 12 mo 6. use of restraints-seclusion criteria -Only to ensure the immediate physical safety of pt and others -No evidence that restraints decrease risk of falls -Last resort -Never as means of discipline, coercion, or for staff convenience -Face to face eval and written order required, eval must be completed within 1 hr of application of restraint/seclusion --not allowed PRN --must reevaluate q24h 7. risk factors of suicide -History of substance abuse -Physical disability/illness -Losing a friend or family member to suicide -Ongoing exposure to bullying behavior 8. mental health condition -Recent death of a family member/close friend -Access to harmful means -Relationship problems -Previous suicide attempts 14. interventions for aggressive behavior When aggression is unavoidable- prioritize security, sedation, and supervision AEIO risk assessment categories 15. Agitation/Arousal: sit still? pacing? demonstrating aggressive behaviors? Environment: Is the pt in a safe location? Id potential exits, equipment in the room, and the distance of the room from the rest of the unit. 16. Intent: pt have thoughts of harming themselves or others? pt having psychotic experiences that may cause them to harm themselves/others? Objects: pt have access to firearms, blades, medications, lighters, or clothing items that could be used to harm themselves/others? 17. de-escalation techniques -is a first-line response to potential violence/ aggression in healthcare settings -aka conflict resolution/crisis management, involves strategies and techniques to reduce a pt's agitation/aggression --Clear, calm, empathetic, nonjudgmental communication --Respect for personal space --Non-confrontational approach --Non-threatening nonverbal communication --Response to pt's expressed problem/condition --Clear limits -Determine risk level/intervention -Determine risk -Choose appropriate intervention to address and reduce risk -Document -Assessment of risk, rationale, intervention, and follow-up 20. lithium toxicity -Lithium has a narrow therapeutic range. -Too much lithium can quickly cause toxicity- lead to acute kidney injury and death -Lithium toxicity may occur- d/t excessive intake related to OD or dosage modifications --may also occur from impaired excretion; when pts experience sodium and fluid depletion from vomiting, diarrhea, fever, or a low sodium diet --lithium is reabsorbed by the kidneys which increases serum levels of the drug 21. how to confirm dx of lithium toxicity lithium level 22. early sxs of lithium tox n/v/d, hand tremors, slurred speech, vision changes. -- chronic tox may present w/o gi sxs 23. later sxs of lithium tox -hyperreflexia and muscle spasms, nystagmus, dysrhythmias, confusion, and delirium. -Seizures and death may occur if- serum lithium concentration exceeds 3.5 mEq/L. --When ANC < 100 28. treatment for CLIA -immediate D/C of clozapine -supportive care for infection (nuetropenic precaitions) -consultation with hematology. -Begin a diff antipsychotic after 2 wk washout 29. prevention of CLIA -serial lab draws weekly during the first 18 wks of treatment with clozapine --then biweekly until 1