CH 25 - Bipolar Boyd PrepU
A client with bipolar disorder has been ordered a medication that is classified as an anticonvulsant. Which drug does the nurse know falls within this class of medications?
Carbamazepine Carbamazepine is an anticonvulsant with mood-stabilizing effects. Lithium is a mood stabilizer. Mannitol and methyldopa are not used in the treatment of bipolar disorder.
Which of the following substances may increase serum lithium concentrations? Select all that apply.
Furosemide Alcohol Fluoxetine Furosemide, alcohol, and fluoxetine may increase serum lithium concentrations. Haloperidol increases neurotoxicity despite normal serum concentrations and dosage. Nonsteroidal anti-inflammatory drugs such as ibuprofen decrease renal clearance of lithium. Ibuprofen increases serum lithium concentrations by 30% to 50% in 3 to 10 days.
A client who has liver damage is receiving lithium for treatment of bipolar disorder. The nurse understands that which of the following may occur when the client is receiving lithium?
Increased plasma concentration Hepatic and renal impairments increase plasma concentration of lithium.
A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy?
Liver function Baseline liver function tests and a complete blood count with platelets should be obtained before starting therapy, and clients with known liver disease should not be given divalproex sodium. There is a boxed warning for hepatotoxicity. Thyroid level, WBC count, and cardiac enzymes do not have to be performed routinely before starting this medication.
It is important for the client in acute mania, receiving lithium, to obtain blood concentrations within which time frame?
Twice weekly In acute mania, it is important for the client to obtain serum concentrations twice weekly in the acute phase. In uncomplicated maintenance, serum concentrations should be obtained every 2 to 3 months.
