Nokea
The nurse is caring for a female client with mood disorder who is prescribed lithium. What interventions should the nurse perform?
- A. Instruct to resume regular activities.
- B. Administer lithium before meals.
- C. Withhold if serum level is less than 1.5 mEq.
- D. Instruct to avoid becoming pregnant.
Correct Answer: D
Rationale: Lithium crosses the placental barrier; therefore, its use is contraindicated in pregnant women. The client should use caution when resuming activities such as driving as drowsiness is a common side effect of lithium. The nurse should withhold the administration of lithium if the serum level is greater than 1.5 mEq. Lithium should be administered with meals.
You may also like to solve these questions
Which nursing consideration is most important when administering medications to a suicidal client?
- A. Do not leave any syringe unattended.
- B. Watch the client place all pills in the mouth.
- C. View the inside of the mouth to make sure that all medications are swallowed.
- D. Remove all medications and medication administration equipment from client area.
Correct Answer: C
Rationale: It is most important for the nurse to view the inside of the mouth when administering medications. This is done by inspecting the client's mouth and under the tongue because clients may 'cheek' medications to stockpile and use the medications. Not leaving syringes unattended, watching the client place the pills in their mouth, and removing all medications and equipment are all appropriate nursing actions, but the most important is not allowing the opportunity for the client to overdose on medications.
The nurse is caring for a client who has selected transcranial magnetic stimulation to treat depression. For which side effect would the nurse provide preprocedural instructions?
- A. Headache
- B. Blurred vision
- C. Hearing loss
- D. Vertigo
Correct Answer: A
Rationale: The most frequent side effect following transcranial magnetic stimulation to treat depression is headache. Preprocedural instruction would include the most common symptom (headache) and interventions (pain management). Blurred vision, hearing loss, and vertigo are not common side effects.
During the assessment of a client with mood disorder, the nurse observes that the client experiences hallucinations and delusions. What form of depressive disorders does the client experience?
- A. Reactive depression
- B. Mania
- C. Psychotic depression
- D. Seasonal affective disorder (SAD)
Correct Answer: C
Rationale: In psychotic depression, an extreme form of depressive disorder, some persons experience hallucinations and delusions. A reactive or secondary depression is a sad feeling that can be directly attributed to a situation or cause. Mania refers to the frenzied state of euphoria exhibited by persons during the manic phase of bipolar disorder. SAD is a mood disorder characterized by depressive feelings that develop during winter months and then disappear in the spring.
The nurse is completing a medication history for a client diagnosed with bipolar disorder. When assessing the medications, which medication classification is noted as an adjunct to lithium therapy?
- A. Antidiabetics
- B. Antihypertensives
- C. Anticonvulsants
- D. Antianginals
Correct Answer: C
Rationale: Anticonvulsant therapy may be co-prescribed for a brief period to sedate the client and relieve bizarre thought processes faster than monotherapy with lithium. Anticonvulsants enhance the action of gamma-aminobutyric acid (GABA) in much the same way that benzodiazepines reduce anxiety and they are believed to inhibit glutamate.
The nurse is caring for a client who is receiving valproic acid. What clinical manifestation should the nurse periodically monitor for?
- A. Hepatotoxicity
- B. Hypertensive crisis
- C. Orthostatic hypotension
- D. Hyper alertness
Correct Answer: A
Rationale: The nurse should closely monitor a client on valproic acid, Depakote or Depakene, for hepatotoxicity. Frequent liver function tests and serum ammonia concentrations may be ordered. When a monoamine oxidase inhibitor is mixed with foods containing tyramine, clients are likely to develop a potentially fatal hypertensive crisis, not when taking valproic acid. Risk for orthostatic hypotension from psychotropic drugs is increased in older adults because of decreased functioning of the blood pressure-regulating mechanism. Some clients administered valproic acid experience sedation and ataxia.