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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A lithium level of 1.0 mEq/L is within the therapeutic range (0.6 to 1.2 mEq/L). The nurse should administer the morning dose of lithium as prescribed.
B. While it is important to monitor for medication adherence, there is no indication from the current lithium level that this client is refusing the medication.
C. Gastric lavage is unnecessary, as the lithium level is not elevated enough to warrant this extreme intervention.
D. Early signs of lithium toxicity typically occur with levels above 1.5 mEq/L. Since the level is 1.0 mEq/L, the nurse should proceed with administering the medication.
Correct Answer is D
Explanation
A. Potassium 4.2 mEq/L is within the normal range (3.5–5.0 mEq/L).
B. Sodium 136 mEq/L is slightly low but does not warrant withholding lithium. However, sodium levels should be monitored regularly as low sodium increases the risk of lithium toxicity.
C. A calcium level of 9.0 mg/dL is within the normal range (8.5–10.2 mg/dL).
D. An elevated creatinine level (2.1 mg/dL) indicates possible renal dysfunction, which is a concern for lithium use. Lithium is excreted by the kidneys, and impaired renal function increases the risk of lithium toxicity.
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