A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?
Assess the patient for gastrointestinal side effects.
Monitor the patient closely for signs of mania.
Administer the medication as ordered
Educate the patient about potential weight gain
The Correct Answer is B
A. While gastrointestinal side effects are common with fluoxetine, they are not the priority concern in the context of bipolar disorder.
B. Fluoxetine (Prozac) is an SSRI used to treat depression, but in patients with bipolar disorder, it can trigger a manic episode. Therefore, the nurse's priority is to monitor for signs of mania, such as increased energy, euphoria, or impulsivity.
C. Administering the medication as ordered is essential, but the nurse must be vigilant for signs of mania, especially with SSRIs in bipolar patients.
D. Educating about weight gain is important but does not address the immediate risk of precipitating mania with fluoxetine in a bipolar patient.
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Related Questions
Correct Answer is D
Explanation
A. A level of 1.8 mEq/L is too high for initial treatment, as it is above the therapeutic range.
B. A level of 1.8 mEq/L is not within the maintenance treatment level, which is typically 0.6–1.2 mEq/L.
C. The level is above the therapeutic level, not below it.
D. A lithium level of 1.8 mEq/L is above the therapeutic range (0.6–1.2 mEq/L) and is considered toxic. Toxicity can lead to serious side effects like tremors, confusion, and renal dysfunction.
Correct Answer is A
Explanation
A. Walking with the nurse in the courtyard provides a simple, safe, and structured activity that promotes physical exercise and reduces excess energy in a way that is appropriate for someone in a manic state. This also gives the nurse an opportunity to observe the client's behavior and provide supervision.
B. Watching a video with a group might not engage the client sufficiently and could be too passive for someone experiencing mania who might need a more stimulating activity.
C. Participating in a basketball game could be too physically demanding and might escalate the client's manic behavior, especially if they have high energy or impulsivity.
D. Joining a group discussion about a local election may not be stimulating enough for the client in a manic state, as it requires focus and attention that might be difficult for the client to maintain during acute mania.
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