Author Question: A client with bipolar disorder is prescribed lithium. The nurse is reviewing the client's medication ... (Read 112 times)

Sportsfan2111 · **on:** Jul 19, 2018

A client with bipolar disorder is prescribed lithium. The nurse is reviewing the client's medication history for drugs that could interact with lithium.

The nurse would monitor the client's serum lithium concentrations closely for toxicity if the client's medication history included which of the following? Select all that apply.

A) Captopril
B) Fluoxetine
C) Hydrochlorothiazide
D) Mannitol
E) Isosorbide

Question 2

After educating a class on the etiology of bipolar disorders, a nursing instructor determines that the education was successful when the class describes the kindling theory as involving which of the following?

A) A dysregulation in the circadian rhythm, leading to sleep disturbance
B) A single gene or sequence of genes causing pathologic changes
C) Exposure to repetitive subthreshold stressors at vulnerable times
D) Wear and tear on the body from mood episodes leading to increased problems

Missbam101 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

Ans: A, B, C
Medications such as captopril, fluoxetine, and hydrochlorothiazide increase serum lithium concentration, placing the client at increased risk for lithium toxicity. Mannitol and isosorbide increase renal excretion of lithium, thus decreasing lithium concentration.

Answer to Question 2

Ans: C
The kindling theory posits that as genetically predisposed individuals experience repetitive, subthreshold stressors at vulnerable times, mood symptoms of increasing intensity and duration occur. Eventually, a full-blown depressive or manic episode erupts. Each episode leaves a trace and increases the person's vulnerability, or sensitizes the person, to have another episode with less stimulation. Chronobiologic theories suggest that circadian dysregulation underlies the sleepwake disturbances of bipolar disorder. Research related to genetic factors suggests that bipolar disorder is highly heritable, although no one gene or sequence of genes is responsible for the pathology of bipolar disorders. The allostatic load (or wear and tear on the body model) bipolar disorder is viewed as a disorder where the allostatic load increases as the number of mood episodes increases, leading to an increase in physical and mental health problems.