A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder? (Select all that apply.)

Fluoxetine and other SSRIs can actually have an impact on sexual desire and function as a side effect, often leading to decreased libido. This statement shows a misunderstanding of the medication's potential effects.

B. "I should notify my provider if I develop a skin rash."

Explanation: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression. It's important for clients to be aware of potential side effects and know when to notify their healthcare provider. One potential serious side effect is an allergic reaction or skin rash, which could indicate an adverse response to the medication. Therefore, the client's statement about notifying the provider if a skin rash develops demonstrates their understanding of monitoring for potential adverse reactions.

C. "I should expect relief from depression within 3 to 4 days."

Antidepressant medications like fluoxetine typically take several weeks to start showing significant improvements in symptoms. This statement reflects a misconception about the timeline for therapeutic effects.

D. "I will take my fluoxetine at bedtime so I can sleep better."

Fluoxetine can have stimulating effects for some individuals, so it's often recommended to take it earlier in the day to avoid interference with sleep. Taking it at bedtime could potentially disrupt sleep rather than improve it.

A. Praise the client for looking at herself in a mirror.

While body image concerns are common in anorexia nervosa, praising the client for looking at herself in a mirror may inadvertently reinforce the focus on appearance and body image, which can be counterproductive.

B. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise.

Explanation: For a client with anorexia nervosa, overexercising can be part of the unhealthy behaviors associated with the disorder. Collaborative communication is important in addressing and managing these behaviors. Asking the client to agree to talk to a nurse whenever the urge to exercise arises is a supportive approach. It allows the nurse to provide emotional support, explore the client's motivations and triggers for overexercising, and work together on finding healthier coping strategies.

C. Reprimand the client about the potential damage that has occurred due to overexercising her body.

Reprimanding the client may lead to feelings of guilt and shame, which are counterproductive in supporting recovery. A more empathetic and supportive approach is needed.

D. Restrict the client from being weighed.

Restricting the client from being weighed might exacerbate anxiety around weight gain and contribute to the client's preoccupation with weight. However, monitoring weight under the supervision of healthcare professionals is important in managing anorexia nervosa.