A nurse is admitting a client who has multiple injuries following a motor vehicle crash. Shortly after admission, the client's partner arrives. He is distraught and blames himself for the accident. Which of the following responses should the nurse make?

A. Lithium: Lithium is a mood stabilizer commonly used in the treatment of bipolar disorder. It helps to control mood swings and prevent the recurrence of manic and depressive episodes.

B. Carbamazepine: Carbamazepine is an anticonvulsant medication that has been found effective in managing mood swings in bipolar disorder. It can help stabilize mood and prevent manic episodes.

C. Valproate (Valproic acid or Divalproex sodium): Valproate is another anticonvulsant medication that is used as a mood stabilizer in bipolar disorder. It can help control manic and mixed episodes.

The following options are not used to treat bipolar disorder:

D. Paroxetine: SSRIs, including paroxetine, carry a risk of inducing mania or hypomania in individuals with bipolar disorder. This risk is why these medications are usually avoided or used cautiously, always in conjunction with a mood stabilizer like lithium, valproate, or atypical antipsychotics. Before initiating paroxetine, it’s crucial that the client is stabilized with a mood stabilizer to minimize the risk of mood switching (i.e., moving from depression to mania or hypomania).

E. Donepezil: Donepezil is a medication used to treat Alzheimer's disease and other forms of dementia. It is not used to treat bipolar disorder.

A. "It doesn't really matter what time you take your medications as long as you don't skip any doses."

While it's important not to skip doses, taking medications at specific intervals is often necessary for maintaining therapeutic blood levels and optimal treatment outcomes. Disregarding specific timing can affect the effectiveness of the medications.

B. "We'll have to talk to your provider about switching to an alternative schedule."

This response may not consider the client's preferences and might not be necessary if the client's current schedule can be adjusted to suit their routine. Collaboration between the nurse and the client is essential.

C. "You really shouldn't change the schedule we established here in the facility."

While continuity in medication schedules is important, if the established schedule doesn't align with the client's daily life, there should be flexibility to adjust it in a way that still maintains the effectiveness of the medications.

D. "Let's work together to devise a time schedule that is convenient for you on a daily basis."

Explanation: It's important to consider the client's lifestyle and routines when developing a medication schedule to ensure optimal adherence. Collaboratively working with the client to create a schedule that fits their daily activities increases the likelihood that they will consistently take their medications as prescribed.