A patient with bipolar disorder has been prescribed lithium. ...

[silviawilliams41]

A patient with bipolar disorder has been prescribed lithium. Which is the priority nursing intervention?
 
  1. Assist the patient in developing self-determination.
  2. Discuss environmental modifications.
  3. Change medications to control side effects.
  4. Teach the patient about the medication.

Question 2

The nurse at a community mental health clinic is planning to refer patients to various members of the community-based recovery team. Which patient would the nurse refer to the psychiatrist?
 
  1. An anxious patient who would benefit from group therapy
  2. A patient with schizophrenia who has housing and employment issues
  3. A patient with bipolar disorder who is experiencing frequent mood cycling
  4. A patient newly diagnosed with panic disorder who needs psychoeducation

[mirabriestensky]

Answer to Question 1

Answer: 4
Explanation: Although community health nurses do assist patients in developing self-determination and making environmental modifications, the priority nursing intervention is to provide patient teaching about the medication and to ensure monitoring of the patient's lithium levels to evaluate the therapeutic level of the drug and to prevent toxicity. If side effects are observed or reported, the nurse should consult with the prescribing provider, who will determine if the medication needs to be changed.

Answer to Question 2

Answer: 3
Explanation: The psychiatrist in a community mental health team usually conducts medication evaluations and prescribes the appropriate medications to help control symptoms. Although the psychiatrist may provide some psychoeducation, providing psychoeducation is within the scope of practice of the nurse and would not necessarily require a referral. Although the psychiatrist may lead group therapy, group therapy may be led by an advanced practice nurse or other clinician who is appropriately trained and certified. Case management services that include addressing housing and employment issues are provided by a case manager, who may belong to a variety of mental health disciplines including nursing and social work.