Xicheng Wong is a 53-year-old widowed Asian male who comes to see you in your office after he was hospitalized for 14 days for a manic episode. Yicheng has bipolar I disorder. He is currently prescribed 1500 mg of divalproex sodium (Depakote ER). He is 5’ 11” and 210 lbs. His most recent VPA level was 45 µg/ml.
From your perspective as Yicheng’s psychiatric nurse practitioner, answer the following questions in a paper no longer than two double-spaced pages (not including the reference page) and in APA format. Include at least three peer-reviewed, evidence-based references.
- Explain why Depakote ER was prescribed for Yicheng.
- Articulate how Depakote ER is metabolized and the mechanism of action, as well as how Depakote is excreted.
- Describe the baseline laboratory and other monitoring that should be done when a patient is prescribed Depakote ER.
- Based on Yicheng’s current Depakote level, describe how you would adjust the Depakote dose, including what dose you would prescribe and the scheduling/time of the dose.
- When would you order the next Depakote level? What additional laboratory tests would you order? How often should the Depakote level be ordered?
- What side effects of Depakote should you discuss with Yicheng?