A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?
A pretreatment electroencephalogram (EEG) will be done.
High serum sodium levels can cause toxic levels of valproate.
Liver function tests must be monitored.
Thyroid function tests should be performed every 6 months
The Correct Answer is C
A. A pretreatment electroencephalogram (EEG) will be done.
An EEG is not typically necessary when starting valproate for bipolar disorder. EEGs are more commonly used to assess brain activity in the context of epilepsy.
B. High serum sodium levels can cause toxic levels of valproate.
Sodium levels are not directly related to the toxic levels of valproate. The primary concern with valproate is its impact on liver function and potential for hepatotoxicity.
C. Liver function tests must be monitored.
Explanation: Valproate is an antiepileptic and mood-stabilizing medication commonly used to treat bipolar disorder. One of the potential side effects of valproate is hepatotoxicity (liver damage). Therefore, monitoring liver function tests (such as serum transaminases) is important to assess the medication's impact on the liver and to ensure the client's safety.
D. Thyroid function tests should be performed every 6 months.
While thyroid function tests might be important for some medications, monitoring thyroid function is not a primary consideration when using valproate. The main focus with valproate is on liver function monitoring.
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Related Questions
Correct Answer is C
Explanation
A. Asking the client to create their own schedule of daily activities may overwhelm them and exacerbate feelings of hopelessness or indecisiveness commonly experienced with depression. The nurse should provide structure and guidance in establishing a manageable routine.
The other options do not align with best practices for caring for a client with major depressive disorder:
B. Teaching passive communication is not appropriate, as assertive communication is typically encouraged to help the client express her needs and feelings effectively.
C.Asking the client to create their own schedule of daily activities may overwhelm them and exacerbate feelings of hopelessness or indecisiveness commonly experienced with depression. The nurse should provide structure and guidance in establishing a manageable routine
D. Limiting involvement in unit activities could further isolate the client and exacerbate her symptoms. Encouraging participation and engagement is generally more beneficial.
Correct Answer is D
Explanation
A. “Taking the medication on an empty stomach will decrease your stomach upset."This is incorrect because taking chlorpromazine on an empty stomach can actually increase the risk of gastrointestinal irritation and upset. It’s generally recommended to take medications that can irritate the stomach lining with food or milk to help buffer the stomach.
B. “Lie down for 30 minutes after each dose to help prevent stomach upset.”This is not a recommended practice for preventing stomach upset. In fact, lying down immediately after taking medication can increase the risk of esophageal irritation and reflux, especially with certain medications.
C. “Talk to your provider about decreasing your dose of medication.”While discussing medication concerns with a healthcare provider is always a good idea, this response does not directly address the immediate issue of stomach upset. The provider might adjust the dose if necessary, but the primary recommendation for reducing stomach upset would be to take the medication with milk.
D. “Drink a glass of milk with each dose of your medication.”Drinking milk with chlorpromazine can help reduce stomach upset by buffering the stomach lining and reducing irritation. This is a common recommendation for medications that can cause gastrointestinal discomfort.
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