A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

A pretreatment electroencephalogram (EEG) will be done.

High serum sodium levels can cause toxic levels of valproate.

Liver function tests must be monitored.

Thyroid function tests should be performed every 6 months

Answer and Explanation

The Correct Answer is C

A. A pretreatment electroencephalogram (EEG) will be done.

An EEG is not typically necessary when starting valproate for bipolar disorder. EEGs are more commonly used to assess brain activity in the context of epilepsy.

B. High serum sodium levels can cause toxic levels of valproate.

Sodium levels are not directly related to the toxic levels of valproate. The primary concern with valproate is its impact on liver function and potential for hepatotoxicity.

C. Liver function tests must be monitored.

Explanation: Valproate is an antiepileptic and mood-stabilizing medication commonly used to treat bipolar disorder. One of the potential side effects of valproate is hepatotoxicity (liver damage). Therefore, monitoring liver function tests (such as serum transaminases) is important to assess the medication's impact on the liver and to ensure the client's safety.

D. Thyroid function tests should be performed every 6 months.

While thyroid function tests might be important for some medications, monitoring thyroid function is not a primary consideration when using valproate. The main focus with valproate is on liver function monitoring.

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Correct Answer is C

Explanation

A. "There really isn't much you can do about that until you are discharged." - This response dismisses the client's feelings and does not offer any support.

B. "You should call your boss and ask if you can have your job back." - This response is directive and may not address the client's emotional needs.

C. "You must feel very concerned and disappointed by that information."

This response shows empathy and acknowledges the client's feelings without making judgments or offering solutions. It validates the client's emotions and opens up a supportive space for further discussion.

D. "I don't understand why your partner would upset you with news like that." - This response may be perceived as judgmental and does not show empathy or understanding.

A. “Taking the medication on an empty stomach will decrease your stomach upset." B. "Lie down for 30 minutes after each dose to help prevent stomach upset." C. "Talk to your provider about decreasing your dose of medication," D. "Drink a glass of milk with each dose of your medication."

Correct Answer is D

Explanation

A. “Taking the medication on an empty stomach will decrease your stomach upset."This is incorrect because taking chlorpromazine on an empty stomach can actually increase the risk of gastrointestinal irritation and upset. It’s generally recommended to take medications that can irritate the stomach lining with food or milk to help buffer the stomach.

B. “Lie down for 30 minutes after each dose to help prevent stomach upset.”This is not a recommended practice for preventing stomach upset. In fact, lying down immediately after taking medication can increase the risk of esophageal irritation and reflux, especially with certain medications.

C. “Talk to your provider about decreasing your dose of medication.”While discussing medication concerns with a healthcare provider is always a good idea, this response does not directly address the immediate issue of stomach upset. The provider might adjust the dose if necessary, but the primary recommendation for reducing stomach upset would be to take the medication with milk.

D. “Drink a glass of milk with each dose of your medication.”Drinking milk with chlorpromazine can help reduce stomach upset by buffering the stomach lining and reducing irritation. This is a common recommendation for medications that can cause gastrointestinal discomfort.

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A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

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