A nurse is assessing a client who is exhibiting symptoms of a manic episode. The client states, "I am the most important person in the world, and I have unique abilities that no one else possesses." What is the appropriate nursing response?

Choice A rationale:

Dry mouth is a common side effect of many medications, but it is not a distinctive side effect of SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors). Dry mouth is more commonly associated with medications that affect salivary gland function, such as anticholinergic drugs.

Choice B rationale:

Weight loss can indeed be a side effect of SNRIs. These medications can impact appetite and metabolism, leading to weight loss in some individuals. However, it is not the most common or distinctive side effect when compared to other options.

Choice C rationale:

Constipation is a side effect that can occur with SNRIs, but it's not as prevalent or characteristic as some other side effects. Constipation is often associated with medications that have anticholinergic effects, which SNRIs generally have to a lesser extent.

Choice D rationale:

(Correct Choice) Insomnia is a well-known side effect of SNRIs. These medications can affect sleep patterns and may cause difficulties falling asleep or staying asleep. This side effect is particularly relevant to discuss with patients because it can impact their quality of life and overall well-being.

Choice A rationale:

Antipsychotics are often used to manage acute manic episodes in bipolar disorder, but they are not considered the gold standard for overall treatment. They may have a role as adjunctive therapy or in specific situations, but they are not typically the primary choice for maintenance treatment.

Choice B rationale:

Antidepressants are used in bipolar disorder treatment, but they are often cautiously prescribed due to the risk of triggering manic episodes or rapid cycling. They are not considered the gold standard due to this potential for destabilization.

Choice C rationale:

Benzodiazepines may be used to manage acute agitation or anxiety in bipolar disorder, but they are not the gold standard for long-term treatment. Prolonged use can lead to dependence and may not address the underlying mood instability.

Choice D rationale:

Mood stabilizers. Mood stabilizers like lithium, valproate (divalproex), and lamotrigine are considered the gold standard for bipolar disorder treatment due to their efficacy in managing both acute episodes (manic, hypomanic, and depressive) and providing long-term stabilization. These medications help prevent relapses and mood swings by regulating neurotransmitters and stabilizing mood fluctuations.