A patient is admitted with bipolar affective disorder. The nurse acknowledges that which medication is used to treat this disorder for some patients in place of lithium?
thiopental
gingko biloba
fluvoxamine (Luvox)
divalproex (Depakote)
Advise the patient to maintain adequate fluid intake of 2 L/d.
The Correct Answer is D
Bipolar affective disorder is commonly managed with mood stabilizers. While lithium remains a first-line therapy, not all patients tolerate it due to side effects, drug interactions, or contraindications. In such cases, anticonvulsants such as divalproex (Depakote) are used as alternatives or adjuncts for mood stabilization.
D. divalproex (Depakote)
– Divalproex is an anticonvulsant that is also FDA-approved for bipolar disorder. It is especially effective in managing acute mania, mixed episodes, and rapid cycling. It is considered a reliable alternative for patients who cannot tolerate lithium due to renal impairment, toxicity risk, or lack of response.
A. thiopental
– Thiopental is a barbiturate used for induction of anesthesia and rapid sedation. It does not have a role in mood stabilization or long-term psychiatric management.
B. gingko biloba
– Ginkgo is an herbal supplement sometimes used to improve memory and circulation. It is not approved or effective for treating bipolar disorder and could potentially interact with psychiatric medications.
C. fluvoxamine (Luvox)
– Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) used for depression and obsessive-compulsive disorder. While it can treat depressive symptoms, SSRIs alone can trigger manic episodes in bipolar patients, making them inappropriate as primary treatment.
Take-Home Points:
- Lithium is first-line for bipolar disorder, but divalproex is a widely used alternative.
- Anticonvulsants such as valproate and carbamazepine can stabilize mood in patients who cannot take lithium.
- SSRIs and herbal supplements are not used as primary therapy for bipolar affective disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E","F"]
Explanation
Lithium is a mood stabilizer widely used in the management of bipolar disorder, particularly for preventing manic and depressive episodes. Because it has a narrow therapeutic range, patients are at risk for toxicity if blood levels fluctuate due to dehydration, drug interactions, or dietary changes. Nurses must closely monitor clients and provide teaching to ensure safety, adherence, and therapeutic effectiveness.
A. Observe the patient for motor tremors — Tremors are one of the earliest and most common signs of lithium toxicity, often appearing before severe symptoms like ataxia, confusion, or seizures. Tremors can indicate even mild elevations in lithium levels and may be exacerbated by stress, fatigue, or changes in hydration. Regular neurological assessments allow the nurse to intervene promptly, adjust therapy if needed, and prevent progression to life-threatening toxicity.
B. Monitor the patient for orthostatic hypotension — Lithium can cause fluid shifts and mild hypotension, especially in older adults or clients on diuretics. Monitoring blood pressure in different positions helps prevent falls, dizziness, and injuries, which are critical considerations in safe patient care.
E. Advise the patient to avoid caffeinated foods and beverages — Caffeine can increase renal excretion of lithium, potentially lowering blood levels and decreasing effectiveness. Clients should be educated on maintaining consistent caffeine intake to avoid fluctuations.
F. Teach the patient to take lithium with meals to decrease gastric irritation — Lithium can cause nausea, vomiting, and diarrhea if taken on an empty stomach. Taking it with food reduces gastrointestinal discomfort and improves medication adherence.
C. Draw lithium blood levels immediately after a dose — Accurate lithium monitoring requires blood to be drawn 12 hours after the last dose. Drawing levels immediately post-dose can give falsely elevated results, leading to unnecessary dose adjustments or alarm.
D. Advise the patient to drink 750 mL/d of fluid in hot weather — Lithium therapy requires maintaining adequate hydration (A.5–3 L/day) to prevent concentration changes and toxicity. 750 mL is insufficient, especially in hot weather or with increased activity.
Take-Home Points:
- Monitor closely for early signs of lithium toxicity, such as tremors, GI upset, and cognitive changes.
- Ensure adequate hydration and dietary consistency to maintain therapeutic lithium levels.
- Provide patient education on timing, meal administration, and avoiding substances that alter lithium excretion.
Correct Answer is ["A","B","C"]
Explanation
- GI upset, confusion, and polyuria are early warning signs of lithium toxicity.
- Severe symptoms such as ataxia and seizures occur in advanced toxicity.
- Continuous monitoring of serum lithium levels and client symptoms is essential to maintain safety.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.