Mood Stabilizers

Question 1

A physician prescribes lithium for a client diagnosed with bipolar disorder. Which of the following topics should a nurse cover when teaching the client? Select all that apply.

Answer 1

2. Signs and symptoms of drug toxicity
3. Need to consistently monitor blood levels
4. Amount of time that may be needed for mood changes to occur

Question 2

mood stabilizers are a lifelong therapy treatment, t or f

Answer 2

true - maintenance drugs

Question 3

benefit of mood stabilizers

Answer 3

prevent depressive and manic episodes

Question 4

when are antipsychotics used

Answer 4

severe manic episodes - calm people, allow their thoughts to be organized
several are approved for mono-therapy

Question 5

antidepressants can be used in bipolar I or II

Answer 5

bipolar II - in addition to mood stabilizer

Question 6

when using antidepressants be careful to avoid

Answer 6

mania

Question 7

when bipolar pt. is erratic with psychosis you can use this type of drug therapy

Answer 7

Benzo’s

Question 8

short-term drug therapy for bipolar disorder

Answer 8

anti-anxiety

anti-psychotics (altered thought process)

Question 9

long-term drug therapy for bipolar disorder

Answer 9

lithium , Depakote and Tegretol (mood stabilizers)

Question 10

1st drug of choice for acute mania

Answer 10

lithium

Question 11

how is lithium excreted

Answer 11

through the kidney’s

Question 12

lithium has a short half-life, t or f

Answer 12

true

Question 13

when sodium is low while taking lithium what can happen

Answer 13

pt. can become toxic

Question 14

what should we teach pt. on lithium

Answer 14

drink 8-8oz glasses of water

Question 15

adverse effects of lithium

Answer 15

tremor, polyuria, goiter, mild nausea

Question 16

contraindications for lithium

Answer 16

renal disease, diuretics (dehydration)

Question 17

levels of lithium must be kept below

Answer 17

1.5

Question 18

how often is blood drawn while taking lithium

Answer 18

every 2 days after started then every 2 weeks then every 1-3 months

Question 19

therapeutic levels of lithium must be kept between

Answer 19

0.4 - 1.0

Question 20

if level of lithium is above 1.0 during therapeutic level what should we do

Answer 20

hold the lithium

Question 21

signs of lithium toxicity

Answer 21

flu-like symptoms that persist

can cause incoordination

Question 22

when is Depakote used

Answer 22

rapid cycling - 4 episodes in 12 months

Question 23

s/e of Depakote

Answer 23

weight gain - GI upset - causes skin problems - teratogenic

Question 24

does Depakote have to be monitored by blood draws

Answer 24

yes

Question 25

another drug used for rapid cycling along w/paranoia

Answer 25

Tegretol - good for men (helps with anger)

Question 26

The presentation of Mr. Quang, a 47-year-old man, at the emergency department is blurred vision, muscle twitching, slurred speech, and severe diarrhea. He shows you, the triage nurse, a card with the following medications listed: lithium carbonate, 300 mg three times daily; clonazepam, 0.5 mg twice daily, both for sleep and agitation.What are your most appropriate actions?

Answer 26

Hold lithium and test his blood level

Question 27

Mr. Quang is transferred from the emergency department to the intensive care psychiatric unit. You note his medical records indicate a diagnosis of bipolar I disorder. His medication orders include: discontinue the lithium carbonate and add lamotrigine on transfer to be titrated up to 100 mg per day.What is the rationale for the medication changes?

Answer 27

Probably toxic.