Bipolar and Depressive disorders CH 26

The physician orders lithium carbonate 600 mg TID for a newly diagnosed patient with bipolar one disorder. There is a narrow margin between therapeutic therapeutic and toxic levels of lithium the therapeutic range for acute mania is: A. 0.5 to 1.5 mEq/L B. 10 to 15 mEq/L C. 0.5 to 1.0 mEq/L D. 5 to 10 mEq/L

A. 0.5 to 1.5 mEq/L

A client who is experiencing a manic episode is admitted to the psychiatric unit after being brought to the emergency department by a family member the client yells my family is trying to make it look like I'm insane they just want to take all my money this behavior is an example of A. A delusion of grandeur B. A delusion of persecution C. Are delusion of reference D. A delusion of control or influence

A. A delusion of persecution

Although historically lithium has been the medication of choice for mania several others have been used with good results which of the following are used in treatment of bipolar disorder? Select all that apply A. Olanzapine B. Oxycodone C. Carbamazepine D. Gabapentin E. Tranylcypromine

A. Olanzapine C. Carbamazepine D. Gabapentin

The nurse is providing medication education to a client on lithium which of the following are more important points to include? Select all that apply A. Significant reductions in sodium intake increase the risk of lithium toxicity B. Weight loss is a common side effect of lithium C. Serum lithium levels will need to be checked at regular intervals without treatment D. Lithium therapy should be continued even during periods when the patient feels well

A. Significant reductions in sodium intake increase the risk of lithium toxicity C. Serum lithium levels will need to be checked at regular intervals without treatment D. Lithium therapy should be continued even during periods when the patient feels well

A client admitted to the inpatient psychiatric unit with bipolar disorder tells the nurse I need to sit in on change of shift report because I have been appointed director of this unit which action by the nurse demonstrates the best clinical judgment at this point? A. Invite a client to sit in on the change of shift report but do not share any confidential client information B. Instruct the client that this is not permitted and redirect the client to other unit activities that are available C. Tell the client that she is delusional but that these symptoms will go away with medication D. Place the client in seclusion for protection of self and others

B. Instruct the client that this is not permitted and redirect client to another unit activities that are available

A client is brought to the emergency department by a family member who reports that the client stopped taking mood stabilizer medications a few months ago and is now agitated, pacing, demanding and speaking very loudly her family member reports that she eats very little, is losing weight, and almost never sleeps what is the priority nursing diagnosis A. Imbalance nutrition: less than body requirements related to not eating B. Risk for injury related to hyper activity C. Disturb sleep pattern related to agitation D. Ineffective coping related to denial of depression

B. Risk for injury related to hyperactivity

A nurse is educating a patient about his lithium therapy and explaining the signs and symptoms of lithium toxicity which of the following would she instruct the patient to be on the alert for A. Fever sore throat Malaise B. Tinnitus, severe diarrhea ataxia C. Occipital headache palpitations chest pain D. Skin rash marked raise in blood pressure bradycardia

B. Tinnitus severe diarrhea ataxia

One way to promote adequate nutritional intake for a client and an acute manic episode who is not eating is to: A. Sit with a client during meals to reinforce the importance of eating everything on the tray B. Have family members bring food from home so the client will have only favorite food C. Provide high calorie nutritious finger foods and snacks that can be eaten on the run D. Restrict the client to their room until they begin to gain weight

C. Provide high calorie nutritious finger foods and snacks that can be eaten on the run

A client experiencing a manic episode enters the Milyer area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse A. Tell the client she cannot wear this outfit while she's in the hospital B. Do nothing and allow her to learn from the responses of her peers C. Quietly walk with her back to her room and help her change into something more appropriate D. Explain to her that if she wears this outfit she must remain in her room

C. Quietly walk with her back to her room and help her change into something more appropriate

What is the most common comorbid condition in children with bipolar disorder? A. Schizophrenia B. Substance abuse C. Oppositional defiant disorder D. Attention deficit hyper activity disorder

D. Attention deficit hyper activity disorder