Author Question: A patient with bipolar disorder who wants to minimize the need for drug therapy asks the nurse what ... (Read 122 times)

panfilo · **on:** Jul 23, 2018

A patient with bipolar disorder who wants to minimize the need for drug therapy asks the nurse what else can be done to treat the disorder. The nurse will recommend which measures? (Select all that apply.)

a. Electroconvulsive therapy
b. Moderate use of alcohol to reduce stress
c. Psychotherapy
d. Regular sleep and exercise
e. Using a chart to monitor mood changes

Question 2

A patient with bipolar disorder is admitted to the hospital. The patient has been taking lithium (Lithobid) for several years and has not been evaluated by a provider for over a year.

Besides obtaining a lithium level, the nurse caring for this patient will anticipate orders for which laboratory tests? (Select all that apply.)
a. Calcium level
b. Complete blood count with differential
c. Liver function tests
d. Renal function tests
e. Serum potassium
f. Thyroid function tests

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

Answer to Question 1

ANS: C, D, E
BPD should be treated with a combination of drugs and adjunctive psychotherapy, because drug therapy alone is not optimal. Other measures, such as regular sleep and exercise and recognizing early symptoms of mood change, help minimize extreme mood swings. Electroconvulsive therapy is effective, but it is not the first-choice treatment; it is reserved for patients who have not responded to other therapies. Avoidance of alcohol is recommended.

Answer to Question 2

ANS: B, D, F
Patients taking lithium can develop a mild, reversible leukocytosis, so annual CBC evaluation with differential is recommended. Chronic lithium use is associated with degenerative changes in the kidneys, so renal function should be assessed annually. Lithium can reduce the incorporation of iodine into thyroid hormone and can inhibit thyroid secretion; therefore, thyroid hormone and thyroid-stimulating hormone (TSH) levels should be measured annually. Lithium is affected by sodium levels but not by calcium or potassium levels. Because lithium is excreted by the kidneys, hepatic function tests are not indicated.