Nokea
A patient diagnosed with bipolar disorder has been hospitalized for 7 days and has taken lithium 600 mg three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene, hyperactivity, and bizarre clothing. What is the nurse's best intervention?
- A. Educate the patient about the proper ways to perform personal hygiene and coordinate clothing.
- B. Continue to monitor and document the patient's speech patterns and motor activity.
- C. Ask the health care provider to prescribe an increased dose and frequency of lithium.
- D. Consider the need to check the lithium level. The patient may not be swallowing medications.
Correct Answer: D
Rationale: Persistent manic symptoms suggest possible nonadherence, warranting a lithium level check. Increasing the dose or other options are less appropriate.
You may also like to solve these questions
Which nursing diagnosis would most likely apply to both a patient diagnosed with major depressive disorder (MDD) as well as one experiencing acute mania?
- A. Deficient diversional activity
- B. Disturbed sleep pattern
- C. Fluid volume excess
- D. Defensive coping
Correct Answer: B
Rationale: Both MDD and mania involve sleep disturbances, making this diagnosis relevant. Other options are less applicable across both conditions.
A patient diagnosed with bipolar disorder has rapid cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?
- A. Phenytoin
- B. Clonidine
- C. Carbamazepine
- D. Chlorpromazine
Correct Answer: C
Rationale: Carbamazepine is effective for rapid-cycling bipolar disorder. Phenytoin and chlorpromazine are not used for mood stabilization, and clonidine is not an anticonvulsant for this purpose.
Lithium is prescribed for a new patient. Which information from the patient's history indicates that monitoring serum concentrations of the drug will be especially challenging and critical?
- A. Arthritis
- B. Epilepsy
- C. Exercise-induced asthma
- D. Congestive heart failure
Correct Answer: D
Rationale: Congestive heart failure and diuretic use complicate fluid balance, increasing lithium toxicity risk. Other conditions do not directly affect lithium monitoring.
This is the primary reason that the cause of bipolar disorder has not been determined?
- A. Several factors, including genetics, are implicated.
- B. Brain structures were altered by trauma early in life.
- C. Excess norepinephrine is probably a major factor.
- D. Excess sensitivity in dopamine receptors may exist.
Correct Answer: A
Rationale: The interplay of multiple factors, including genetics and neurotransmitter imbalances, is the most likely explanation for bipolar disorder. Other options are too specific or narrow.
A patient diagnosed with bipolar disorder is dressed in a red leotard and brightly colored scarves. The patient cusses while twirling and shadowboxing. Then the patient says gaily, 'Do you like my scarves? Here... they are my gift to you.' How should the nurse document the patient's mood?
- A. Labile and euphoric
- B. Irritable and belligerent
- C. Highly suspicious and arrogant
- D. Excessively happy and confident
Correct Answer: A
Rationale: The patient has demonstrated angry behavior and pleasant, happy behavior within seconds of each other. Excessive happiness indicates euphoria. Mood swings are often rapid and seemingly without understandable reason in patients who are manic. These swings are documented as labile.