Priority nursing assessments and patient teaching for patients with bipolar disorder prescribed lithium, SSRI’s and atypical antipsychotics
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Nursing Assessment for SSRIs:
Mental Status Examination:
Assess mood, thought process, affects, and cognitive function.
Monitor for signs of mania or hypomania, as SSRIs can potentially trigger these episodes in bipolar patients.
Medication History:
Review the patient’s history of psychiatric medications to identify previous responses or adverse effects.
Confirm adherence to prescribed medications and any recent changes in dosage.
Side Effects Monitoring:
Regularly assess for common side effects of SSRIs, such as gastrointestinal disturbances (nausea, diarrhea), sexual dysfunction, insomnia, and weight changes.
Monitor for more serious side effects like serotonin syndrome (symptoms include confusion, rapid heart rate, and high blood pressure).
Suicidal Ideation Assessment:
Evaluate the patient’s risk for suicide or self-harm, especially during medication initiation or dose adjustments.
Use standardized tools to assess suicidal thoughts and behaviors.
Vital Signs Monitoring:
Regularly check vital signs to detect any physiological changes due to medication effects.
Lab Tests:
Consider baseline laboratory tests (e.g., liver function tests) to monitor potential drug interactions or side effects if indicated.
Family and Social Support Assessment:
Evaluate the support system available to the patient, including family dynamics and social resources to aid recovery.