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

Answer and Explanation

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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Correct Answer is C

Explanation

A. Respiratory acidosis would present with a low pH (acidotic) and a high PaCO2, which is not the case here.

B. Metabolic alkalosis would be suggested by an elevated pH and elevated HCO3, but here, the bicarbonate level is normal (24 mEq/L).

C. Respiratory alkalosis is indicated by a pH of 7.50 (alkalosis) and a PaCO2 of 30 mmHg, which is lower than the normal range (35-45 mmHg). This low PaCO2 suggests that the patient is hyperventilating, likely due to anxiety, which causes the body to excrete too much CO2.

D. Metabolic acidosis would present with a low pH and a low bicarbonate level, neither of which are seen in this case.

A. Identify anxiety-producing situations. B. Try to repress feelings of anxiety. C. Contact the crisis counselor once a week. D. Eliminate stress and anxiety from daily life.

Correct Answer is A

Explanation

A. Helping the client identify anxiety triggers is a crucial step in managing chronic anxiety. This allows the client to develop coping strategies and minimize stressors.

B. Repressing feelings of anxiety is not a healthy coping mechanism. Acknowledging and addressing anxiety through appropriate strategies is essential.

C. While contacting a counselor is beneficial, weekly contact is not typically needed for chronic anxiety management unless specified by the care plan.

D. It is unrealistic to eliminate all stress and anxiety. The goal is to manage and cope with these feelings, not to eliminate them completely.

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A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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