Bipolar Disorder

Question 1

When administering valproic acid to a patient, what are the labs that need to be consistently monitored?

Answer 1

AST ALT LDH levels

Question 2

If a patient is taking lamotrigine, what side effect requires immediate intervention?

Answer 2

Back red and itchy, Steven-Johnson’s syndrome

Question 3

When a patient is exhibiting mania, what diet are they supposed to be restricted to?

Answer 3

Finger foods: nuggets, cheeseburger, fries, string cheese, crackers

Question 4

When would you do a blood draw on a patient that is taking lithium?

Answer 4

Lithium blood draw is only during the morning 10-12 hours after administration: 9am

Question 5

What are the therapeutic levels for lithium?

Answer 5

0.8-1.4 (If above hold medication)

Question 6

If a patient with bipolar disorder is offering you a gift, how would you respond?

Answer 6

You cannot accept gifts from a patient exhibiting mania

Question 7

What is the safety priority for patients exhibiting extreme mania?

Answer 7

Hyperactivity leads to exhaustion

Question 8

A patient is taking Cover VPA. If the patient cannot swallow the enteric-coated tablets, what is the nurse’s priority?

Answer 8

Request provider to change to syrup form

Question 9

A client claims that objects are far away and becoming small. The nurse should identify this as?

Answer 9

Derealization

Question 10

If a patient says they are having constant nightmares, what should the nurse anticipate administering?

Answer 10

Prazosin (Minipres) or Topamax topirimate

Question 11

If a patient is on buspirone and states that they do not feel any change, how should the nurse respond?

Answer 11

Buspirone takes 2-4 weeks to be fully therapeutic

Question 12

What are some signs that a patient is experiencing HIGH levels of lithium toxicity?

Answer 12

Ataxia, AOL, coma, seizure

Question 13

What are some expected side effects of a patient taking lithium?

Answer 13

Hand tremors, nausea, mild thirst, and GI upset

Question 14

What are some commonly used anti-anxiety medications?

Answer 14

Wellbutrin, Lyrica, Buspar, Vistaril

Question 15

What are some common signs of ASD (Acute Stress Disorder)?

Answer 15

Avoiding people, hypervigilance, irritability and anger

Question 16

A patient is found to be copying another patient’s mannerisms. What would the nurse document this as?

Answer 16

Identification

Question 17

What level of anxiety would you classify a nervous student?

Answer 17

MILD anxiety

Question 18

How should a nurse intervene with a patient who has rigorous rituals due to their OCD?

Answer 18

Plan around the patient’s rituals

Question 19

If a patient is agoraphobic, what are some interventions that should be done to help improve the patients fears?

Answer 19

Promote ADL and be independent

Question 20

A patient is seen having a respiration rate of 30, and their heart rate is going up. How should the nurse identify their level of anxiety?

Answer 20

MODERATE anxiety

Question 21

A patient is found standing on a table fully nude. How should the nurse respond to this situation?

Answer 21

Bring them down and cover them

Question 22

What are some common signs and symptoms of PTSD?

Answer 22

Poor self image, difficult concentration, and recurring nightmares

Question 23

A patient is diagnosed with GAD (generalized anxiety disorder) and is pacing back and forth. How should the nurse intervene

Answer 23

Walk with the pt to slow down the pace

Question 24

A coworker is known to hate another coworker but still gives them gifts and is very helpful to them. What would this identify as?

Answer 24

Reaction formation