Depakote Psych RN

What is Depakote used for?

How Does Depakote Work?The nerve activity is normally kept in balance by a natural chemical in the brain called GABA. When GABA is released in the brain it acts as a natural calming agent. Once GABA is broken down in the brain, it can no longer act on the nerves. When only small amounts of GABA are present, the brain may become 'overexcited'.

Valproate semisodium prevents the breakdown of GABA in the brain. This enables more GABA to be available to calm nerve cells for a longer period of time. By calming the nerve cells, valproate semisodium prevents excessively rapid and repetitive firing of electrical signals. This stabilizes the electrical nerve activity in the brain and is thought to explain how valproate semisodium calms periods of mania.

Who is contraindicated for Depakote?Patient may appear: Yellowish in the skin or eyes ,Have a distended Firm Abdomen aka AscitesComplains of Nausea/Vomiting

Patient may appear: MalnourishedSmells of Alcohol/Poor hygieneSays things referring to alcohol frequentlyNeed to drink in order to relaxHas a history of using dangerous situations linked back to alcohol

Patient may be:NewlywedMy boyfriend/husband/wife wants a familySays things like Trying to start a family soon or I'm ready to have a childStopped taking birth control recentlyYoung teen who may be sexually active

Pregancy D Cleft Palate, Spina Bifida, Cardiac Defects Linked To Depakote

What are the adverse effects of Depakote?

Who should be cautious about taking Depakote?

What are the dosages available for Depakote?Nursing Drug Guide: Max of PO 750 Mg/Day In Divided Doses Least Invasive First!

Nursing Consideration for your patient receiving DepakoteDoes my patient fit any of the Contraindicated criteria?Labs Baseline Platelet and Bleeding TestLiver Function Tests When liver cells are damaged or destroyed, the enzymes in the cells leak out into the blood, where they can be measured by blood tests. Liver tests check the blood for two main liver enzymes:Aspartate aminotransferase (AST) & Alanine aminotransferase (ALT)

TeachingReport any signs of spontaneous bleeding or pin-point dots on the, dark stool, nose bleeds, bleeding gumsReport any signs of confusion, altered mental status, worsening behaviorStop taking if you notice skin turning a yellowish tint, dark urine, experiencing light stools or diarrhea, loss of appetite, RLQ Pain/TendernessDo NOT drink Alcohol Come in to have LFTs/Blood Panel done once a year.If you're wanting to start a family or had one of those nights and think you may be pregnant quickly consult your doctor to have medication changed to something that will not harm the baby.You'll most likely gain weight so might want to work out more or modify your eating habits

Newly diagnosed patient with Bipolar Disorder will be started on Depakote to help stabilize their manic and depressive episodes. Which information from a patient would be a contraindication to this medication? Select All That Apply :DA. I rarely eat anything, all I need is my E&J Brandy to make me feel good.B. I'm so excited I think my husband and I may be expecting our first child.C. I drink energy drinks all the timeD. Unfortunately, I have end-stage liver disease so that's rough to deal with.A Nurse is educating her patient about their newly prescribed Depakote for Bipolar Disorder. Which of the statements by the patient demonstrates successful understanding of teaching? A. I'll call the doctor as soon as I see halos or flashes of lightB. I will come in periodically for my blood tests and liver function tests.C. Social Drinking is still alright as long as it doesn't exceed 2 drinks.D. Bleeding gums is a common side effect and I should not worry.As the nurse you should be alert to elevations in which of the following labs for a patient who has been taking Depakote for the past 6 months:A. Elevated BUN and Creatinine B. Decrased LipaseC. Elevated AST and ALTD. Blood Glucose above 160