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

[PhilipSeeMore]

A patient with bipolar disorder has been prescribed valproate. What precautions should the nurse explain to the patient as a result of possible drug interactions?
 
  1. Taking valproate with clozapine decreases the effect of valproate.
  2. Taking valproate with antacids can result in toxic levels of valproate.
  3. Taking valproate with aspirin can result in toxic levels of valproate.
  4. Taking valproate with lithium decreases the effectiveness of lithium.

Question 2

A patient is complaining of being unable to get to sleep. There is a PRN order for temazepam. What should the nurse do? Select all that apply.
 
  1. Check the PRN protocol.
  2. Assess the patient's need.
  3. Assess the patient's safety.
  4. Review the patient's diagnosis.
  5. Explore the patient's expectations.

[jgranad15]

Answer to Question 1

Answer: 3
Explanation: Aspirin can increase the free concentration of valproate and result in toxic drug levels. Antacids, lithium, and clozapine have not been noted to have any significant interactive effect with valproate.

Answer to Question 2

Answer: 1, 2, 3
Explanation: The PRN order should specify the signs and symptoms, maximum daily dosage, and any specific instructions. The nurse should check the order and assess the patient's need and safety before administering any PRN medication. Although discussing expectations with the patient may be helpful, this is not a necessary part of PRN administration. Reviewing the patient's diagnosis is not part of the PRN protocol.