Question

A client with bipolar disorder has a morning divalproex (Depakote) level of \(75 \mathrm{mcg} / \mathrm{mL}\). The nurse should: A. Request additional medication B. Take no action; the level is therapeutic C. Request another level in the evening D. Omit the next dose of medication

Short answer

A. Request an increase in medication B. Take no action; the level is therapeutic C. Request an additional level check D. Skip the next dose

Step-by-step solution

Review the Therapeutic Range

Look up and understand the therapeutic range of divalproex levels in patients with bipolar disorder. The therapeutic range is typically 50-125 mcg/mL.

Compare the Patient's Level to Therapeutic Range

The given divalproex level for the client is 75 mcg/mL. Compare this level to the therapeutic range (50-125 mcg/mL) to determine if the level falls within the desired range.

Determine the Appropriate Action

If the patient's divalproex level falls within the therapeutic range (50-125 mcg/mL), the appropriate action would be to take no action as the level is therapeutic. In this case, the level is 75 mcg/mL, which is within the therapeutic range. The correct answer is: B. Take no action; the level is therapeutic.

Key concepts

NCLEX-PN Exam Prep

Preparing for the NCLEX-PN (National Council Licensure Examination-Practical Nurse) is a critical step for practical nursing students. A crucial aspect of the exam involves understanding pharmacology and the administration of medications. In the context of the exam, you may be presented with scenarios involving patients' laboratory values, just as in the provided exercise where a nurse must interpret a divalproex level.

Students should focus on mastering content areas such as medication classifications, indications, therapeutic levels, side effects, and interactions. Familiarize yourself with therapeutic ranges of common medications used for bipolar disorder and other conditions. Also, practice making decisions based on those levels, as prompt and accurate interpretation can heavily influence patient outcomes and is often tested on the exam.

Use study resources that provide a combination of theoretical knowledge and practical application exercises. Take practice tests to assess your readiness, ensure you understand lab value interpretation, and can make decisions about patient care confidently.

Bipolar Disorder Management

Bipolar disorder is a mental health condition characterized by extreme mood swings, which include emotional highs (mania or hypomania) and lows (depression). The management of bipolar disorder typically involves the use of mood stabilizers, among other medicinal interventions.

Mood stabilizers such as divalproex (Depakote) play a vital role in managing the manic episodes. Effective management necessitates the maintenance of therapeutic blood levels of these medications to ensure efficacy and minimize side effects. The therapeutic range of divalproex is usually between 50-125 mcg/mL. Professionals who work with bipolar disorder patients should be adept at adjusting dosages based on therapeutic levels and individual patient responses.

Educating patients about their medication, possible side effects, and the importance of regular blood tests to monitor drug levels is also an integral part of nursing responsibilities in bipolar disorder management.

Nursing Pharmacology

Nursing pharmacology is a foundational component of nursing practice that involves the study and administration of medications. It includes understanding the mechanisms of action, therapeutic uses, and potential side effects of drugs. Nurses must be familiar with a range of medications, including psychiatric drugs like divalproex used for the management of bipolar disorder, and be able to apply this knowledge to clinical practice.

Pharmacological knowledge extends to the interpretation of lab values to ensure drug effectiveness and patient safety. Knowing the therapeutic levels, as in the case of divalproex, is necessary to prevent subtherapeutic dosing or toxicity. Precision in medication dosage requires an in-depth understanding of drug pharmacokinetics and pharmacodynamics.

In their everyday practice, nurses must perform accurate medication calculations, assess patients for medication responses, manage potential drug interactions, and educate patients about proper medication use and adherence.

Laboratory Value Interpretation

Laboratory value interpretation is a critical skill in nursing, as it informs clinical decision-making. Understanding and acting upon lab results is fundamental to patient care and safety. Nurses must know the normal ranges of lab values, like the therapeutic level of divalproex, and what it means when a value falls outside these ranges.

Upon receiving lab results, such as a divalproex level, nurses should evaluate if the value is within the therapeutic range (50-125 mcg/mL for divalproex). If it is, as in the exercise example with a level of 75 mcg/mL, no action may be needed, indicating effective management of the patient's condition.

In the case of abnormal values, nurses must be prepared to take appropriate actions, which could include retesting, adjusting medication doses, or initiating other interventions. They also need to communicate and collaborate effectively with the healthcare team to ensure comprehensive care.