Author Question: A patient recently diagnosed with bipolar disorder has been admitted to the unit with severe mania. ... (Read 107 times)

rl · **on:** Jul 23, 2018

A patient recently diagnosed with bipolar disorder has been admitted to the unit with severe mania.

Home medications include valproic acid (Depakene). An antipsychotic medication is added to the medication regimen as a STAT order. After the new medication is explained to the patient, he states, I'm not crazy. Why am I receiving this antipsychotic medication? What is the nurse's most appropriate response to the patient?
a. The antipsychotic drug reduces your manic episode.
b. The antipsychotic will help control symptoms during severe manic episodes.
c. The antipsychotic allows higher levels of valproic acid without signs of toxicity.
d. The antipsychotic is actually the primary drug therapy for bipolar disorder.

Question 2

A nurse is reviewing a patient's laboratory findings prior to medication administration. The most recent serum lithium level is 2.2 mEq/L and was drawn yesterday.

The patient takes 300 mg of lithium carbonate 4 times a day. Which of the following is the nurse's most appropriate action?
a. Administer the drug as prescribed.
b. Recognize that the dose is subtherapeutic.
c. Administer half of the dose.
d. Hold the next dose and notify the prescriber.

duy1981999 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
In patients with bipolar disorder, antipsychotic drugs are given to help control symptoms during severe manic episodes, even if psychotic symptoms are absent. The antipsychotic drugs usually are given in combination with a mood stabilizer.
The antipsychotic drug addresses the symptoms, not the duration, of the manic episode.
Antipsychotic medications do not affect valproic acid levels.
Antipsychotics are not the primary therapy for bipolar disorder.

Answer to Question 2

ANS: D
The lithium level is toxic, therefore the dose should be held and the prescriber notified.
The drug should not be administered as prescribed, because it will increase the toxicity.
The dose is not subtherapeutic; rather, the patient's lithium level indicates toxicity.
It is up to the prescriber to change the dosage ordered. Changing the dosage without discussing it with the prescriber is a violation of the Nurse Practice Act, because nurses do not prescribe.