Author Question: A patient recently was diagnosed with bipolar disorder. The patient, who has a history of seasonal ... (Read 94 times)

rlane42 · **on:** Jul 23, 2018

A patient recently was diagnosed with bipolar disorder. The patient, who has a history of seasonal allergies, is an athlete who participates in track.

The nurse is teaching the patient about lithium (Lithobid), which the prescriber has just ordered. Which statement by the patient indicates the need for further teaching?
a. I can continue to use ibuprofen as needed for muscle pain.
b. I should drink extra fluids before and during exercise.
c. I should not use antihistamines while taking lithium.
d. I should report muscle weakness and tremors to my provider.

Question 2

A patient taking an MAOI is seen in the clinic with a blood pressure of 170/96 mm Hg. What will the nurse ask this patient?

a. Whether any antihypertensive medications are used
b. Whether the patient drinks grapefruit juice
c. To list all foods eaten that day
d. Whether SSRIs are taken in addition to the MAOI

Eazy416 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
Because nonsteroidal anti-inflammatory drugs (NSAIDs) can increase lithium levels as much as 60, they should not be used by patients taking lithium. Aspirin does not have this effect. Lithium induces polyuria in 50 to 70 of patients, so patients should be advised to drink extra fluids, especially during exercise. Antihistamines have anticholinergic effects, which cause urinary hesitancy; this can be uncomfortable when patients experience the polyuria associated with lithium use. Muscle weakness and tremors can occur with lithium; tremors can be treated with beta blockers or by altering the lithium regimen.

Answer to Question 2

ANS: C
Patients taking an MAOI should be counseled to follow strict dietary restrictions and to avoid all foods containing tyramine. Patients who consume such foods when taking an MAOI experience a hypertensive episode. Antihypertensive medications, given with an MAOI, will result in hypotension. Grapefruit juice does not alter the metabolism of an MAOI. SSRIs and MAOIs, when administered together, cause a serotonin syndrome.