A client has been diagnosed with major depressive episode. After treatment with fluoxetine (Prozac), the client exhibits pressured speech and flight of ideas. Based on this symptom change, which physician action would the nurse anticipate?
1. Increase the dosage of fluoxetine.
2. Discontinue the fluoxetine and rethink the client's diagnosis.
3. Order benztropine (Cogentin) to address extrapyramidal symptoms.
4. Order olanzapine (Zyprexa) to address altered thoughts.
2
Rationale: A full manic episode emerging during antidepressant treatment (medication, electroconvulsive therapy, etc.), but persisting beyond the physiological effect of that treatment is sufficient evidence for a manic episode and, therefore, a Bipolar I diagnosis.
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