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Divalproex (Depakote) Nursing Considerations

Divalproex (Depakote) Nursing Considerations

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Outline

Generic Name

Divalproex

Trade Name

Depakote

Indication

Seizures, manic episodes, prevention of headache

Action

Increases the level of GABA (inhibitory neurotransmitter) in CNS

Therapeutic Class

Anticonvulsant, vascular headache suppressants

Pharmacologic Class

None

Nursing Considerations

• May cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity,
pancreatitis
• Increases risk for bleeding with Warfarin
• Use caution with MAOIs
• Monitor liver function tests

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Transcript

Okay, let’s talk about Divalproex, also known as Depakote. This is an oral medication, as you can see here from the packaging, but it also comes in an IV form. So remember when we talk about the therapeutic class, we are talking about how the drug works in the body while the pharmacologic class is the chemical effect. In this case, Divalproex does not have a pharmacologic class while the therapeutic class of Divalproex is an anticonvulsant and vascular headache suppressant. So Divalproex works by increasing the level of GABA in the central nervous system and is indicated for the treatment of seizures, manic episodes, and the prevention of headaches as low levels of GABA are said to be linked to epilepsy, anxiety, chronic pain and mood disorders. So this all makes sense.
Some of the side effects that we see with Divalproex are agitation, dizziness, and insomnia. Some nursing considerations with Divalproex. Monitor liver function tests in your patients, be aware that this medication can cause suicidal thoughts, hepatotoxicity, and pancreatitis. There is an increased risk of bleeding if the patient is also on warfarin. Use caution if your patient is also on MAOIs. Teach the patient to report immediately any thoughts and feelings of suicide to the provider. And guys serum drug level monitoring of seizure medications. Like this one is super important. There are often wide ranges stated in literature, but some patients may require less than that while other patients require more. So do not be surprised if there is a variation in the amount of medication needed for seizure control in your patient. That’s it for Divalproex or Depakote. Now go out and be your best self today. And as always happy nursing.

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Concepts Covered:

Study Plan Lessons

08.01 Psychological Review for CCRN Review

Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)

Albumin Lab Values

Alcohol Withdrawal (Addiction)

Alcohol Withdrawal Case Study (45 min)

Alcoholism – Outcomes Nursing Mnemonic (BAD)

Alprazolam (Xanax) Nursing Considerations

Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)

Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)

Ammonia (NH3) Lab Values

Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)

Antianxiety Meds

Antianxiety Meds

Antidepressants

Antidepressants

Anxiety Disorders (PTSD, Anxiety, Panic Attack) for Certified Emergency Nursing (CEN)

Atypical Antipsychotics

Benzodiazepines

Benzodiazepines Nursing Mnemonic (Donuts and TLC)

Blood Urea Nitrogen (BUN) Lab Values

Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)

Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)

Buspirone (Buspar) Nursing Considerations

Calcium-Ca (Hypercalcemia, Hypocalcemia)

Carbamazepine (Tegretol) Nursing Considerations

Chloride-Cl (Hyperchloremia, Hypochloremia)

Chlorpromazine (Thorazine) Nursing Considerations

Cholesterol (Chol) Lab Values

Cognitive Impairment Disorders

Creatinine (Cr) Lab Values

Day in the Life of a Hospice, Palliative Care Nurse

Day in the Life of a Mental Health Nurse

Defense Mechanisms

Defense Mechanisms

Dementia Nursing Mnemonic (DEMENTIA)

Depression Assessment Nursing Mnemonic (SIGNS)

Depression Concept Map

Diazepam (Valium) Nursing Considerations

Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)

Dissociative Disorders

Divalproex (Depakote) Nursing Considerations

Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)

Encephalopathy Case Study (45 min)

End of Life for Progressive Care Certified Nurse (PCCN)

End-of-Life and Palliative Care (Organ and Tissue Donation, Advance Directives, Care Withholding, Family Presence) for Certified Emergency Nursing (CEN)

Escitalopram (Lexapro) Nursing Considerations

Fluoxetine (Prozac) Nursing Considerations

Generalized Anxiety Disorder

Glomerular Filtration Rate (GFR)

Haloperidol (Haldol) Nursing Considerations

Handling Death and Dying

Head to Toe Nursing Assessment (Physical Exam)

Homicidal and Suicidal Ideation for Certified Emergency Nursing (CEN)

Hypochondriasis (Hypochondriac)

Lamotrigine (Lamictal) Nursing Considerations

Lithium (Lithonate) Nursing Considerations

Lithium Lab Values

Liver Function Tests

Lorazepam (Ativan) Nursing Considerations

Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)

Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)

MAO Inhibitors Nursing Mnemonic (TIPS)

Meds for Alzheimers

Mental Health Course Introduction

Metabolic Alkalosis

Methadone (Methadose) Nursing Considerations

Midazolam (Versed) Nursing Considerations

Mood Disorders (Bipolar, Depression) for Certified Emergency Nursing (CEN)

Mood Disorders (Bipolar)

Mood Stabilizers

Mood Stabilizers

Nurse-Patient Relationship

Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens

Nursing Care Plan (NCP) for Alzheimer’s Disease

Nursing Care Plan (NCP) for Anxiety

Nursing Care Plan (NCP) for Depression

Nursing Care Plan (NCP) for Dissociative Disorders

Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)

Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)

Nursing Care Plan (NCP) for Paranoid Disorders

Nursing Care Plan (NCP) for Personality Disorders

Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)

Nursing Care Plan (NCP) for Schizophrenia

Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)

Nursing Care Plan (NCP) for Suicidal Behavior Disorder

Nursing Case Study for (PTSD) Post Traumatic Stress Disorder

Nursing Case Study for Bipolar Disorder

Nursing Case Study for Mania (Manic Syndrome)

Olanzapine (Zyprexa) Nursing Considerations

Oxycodone (OxyContin) Nursing Considerations

Palliative Care for Progressive Care Certified Nurse (PCCN)

Paranoid Disorders

Paroxetine (Paxil) Nursing Considerations

Personality Disorders

Phases of Nurse-Client Relationship

Phosphorus-Phos

Post-Traumatic Stress Disorder (PTSD)

Postmortem Care

Potassium-K (Hyperkalemia, Hypokalemia)

Psychological Disorders (Anxiety, Depression) for Progressive Care Certified Nurse (PCCN)

Quetiapine (Seroquel) Nursing Considerations

Schizophrenia Case Study (45 min)

Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)

Sertraline (Zoloft) Nursing Considerations

Sodium-Na (Hypernatremia, Hyponatremia)

Somatoform Disorder Case Study (30 min)

SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)

Substance Abuse (Alcohol, Drug Withdrawal) for Progressive Care Certified Nurse (PCCN)

Substance Abuse (Chronic Alcohol Abuse, Chronic Drug Abuse) for Progressive Care Certified Nurse (PCCN)

Substance Abuse (Drug-Seeking Behavior) for Progressive Care Certified Nurse (PCCN)

Suicidal Behavior

Therapeutic Communication

Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)

Thought Disorders (Psychosis, Schizophrenia) for Certified Emergency Nursing (CEN)

Total Bilirubin (T. Billi) Lab Values

Types of Schizophrenia

Urinalysis (UA)

Vitamin B12 Lab Values

Day in the Life of a Community Health Nurse

Degree Restrictions in Career Growth

Environmental Stewardship (Waste Minimization) for Certified Perioperative Nurse (CNOR)

Impaired or Disruptive Behavior Reporting (Interdisciplinary Healthcare Team) for Certified Perioperative Nurse (CNOR)

Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)

Maslow’s Hierarchy of Needs in Nursing

MSN (Masters) vs. DNP (Doctorate)

Quality Improvement Participation for Certified Perioperative Nurse (CNOR)

Caring Practices for Progressive Care Certified Nurse (PCCN)

Congestive Heart Failure (CHF) Labs

End-of-Life and Palliative Care (Organ and Tissue Donation, Advance Directives, Care Withholding, Family Presence) for Certified Emergency Nursing (CEN)

Ethical Dilemmas for Certified Emergency Nursing (CEN)

Famotidine (Pepcid) Nursing Considerations

Implant Verification and Availability for Certified Perioperative Nurse (CNOR)

Maslow’s Hierarchy of Needs in Nursing

Myocardial Infarction (MI) Case Study (45 min)

Nursing Care Plan (NCP) for Abdominal Pain

Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage

Nursing Care Plan (NCP) for Activity Intolerance

Nursing Care Plan (NCP) for Acute Kidney Injury

Nursing Care Plan (NCP) for Acute Pain

Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome

Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)

Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens

Nursing Care Plan (NCP) for Alzheimer’s Disease

Nursing Care Plan (NCP) for Anaphylaxis

Nursing Care Plan (NCP) for Anemia

Nursing Care Plan (NCP) for Angina

Nursing Care Plan (NCP) for Aortic Aneurysm

Nursing Care Plan (NCP) for Appendicitis

Nursing Care Plan (NCP) for Arterial Disorders

Nursing Care Plan (NCP) for Asthma

Nursing Care Plan (NCP) for Attention Deficit Hyperactivity Disorder (ADHD)

Nursing Care Plan (NCP) for Bladder Cancer

Nursing Care Plan (NCP) for Blunt Chest Trauma

Nursing Care Plan (NCP) for Bone Cancer (Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma)

Nursing Care Plan (NCP) for Bowel Obstruction

Nursing Care Plan (NCP) for Brain Tumors

Nursing Care Plan (NCP) for Breast Cancer

Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)

Nursing Care Plan (NCP) for Bronchoscopy (Procedure)

Nursing Care Plan (NCP) for Cardiogenic Shock

Nursing Care Plan (NCP) for Cardiomyopathy

Nursing Care Plan (NCP) for Cerebral Palsy (CP)

Nursing Care Plan (NCP) for Cervical Cancer

Nursing Care Plan (NCP) for Cholecystitis

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Chronic Kidney Disease

Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)

Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate

Nursing Care Plan (NCP) for Clubfoot

Nursing Care Plan (NCP) for Colorectal Cancer (Colon Cancer)

Nursing Care Plan (NCP) for Congenital Heart Defects

Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)

Nursing Care Plan (NCP) for Constipation / Encopresis

Nursing Care Plan (NCP) for Cushing’s Disease

Nursing Care Plan (NCP) for Cystic Fibrosis

Nursing Care Plan (NCP) for Decreased Cardiac Output

Nursing Care Plan (NCP) for Dehydration & Fever

Nursing Care Plan (NCP) for Dementia

Nursing Care Plan (NCP) for Depression

Nursing Care Plan (NCP) for Diabetes

Nursing Care Plan (NCP) for Diabetes Insipidus

Nursing Care Plan (NCP) for Diabetes Mellitus (DM)

Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)

Nursing Care Plan (NCP) for Dissociative Disorders

Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis

Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)

Nursing Care Plan (NCP) for Ectopic Pregnancy

Nursing Care Plan (NCP) for Emphysema

Nursing Care Plan (NCP) for Encephalopathy

Nursing Care Plan (NCP) for Enuresis / Bedwetting

Nursing Care Plan (NCP) for Epididymitis

Nursing Care Plan (NCP) for Fluid Volume Deficit

Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)

Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia

Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed

Nursing Care Plan (NCP) for Glomerulonephritis

Nursing Care Plan (NCP) for Gout / Gouty Arthritis

Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis

Nursing Care Plan (NCP) for Heart Valve Disorders

Nursing Care Plan (NCP) for Hemophilia

Nursing Care Plan (NCP) for Hepatitis

Nursing Care Plan (NCP) for Herpes Zoster – Shingles

Nursing Care Plan (NCP) for Hydrocephalus

Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

Nursing Care Plan (NCP) for Hyperparathyroidism

Nursing Care Plan (NCP) for Hypertension (HTN)

Nursing Care Plan (NCP) for Hyperthyroidism

Nursing Care Plan (NCP) for Hypoglycemia

Nursing Care Plan (NCP) for Hypothyroidism

Nursing Care Plan (NCP) for Impaired Gas Exchange

Nursing Care Plan (NCP) for Imperforate Anus

Nursing Care Plan (NCP) for Impetigo

Nursing Care Plan (NCP) for Incompetent Cervix

Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)

Nursing Care Plan (NCP) for Kidney Cancer

Nursing Care Plan (NCP) for Leukemia

Nursing Care Plan (NCP) for Lung Cancer

Nursing Care Plan (NCP) for Lyme Disease

Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)

Nursing Care Plan (NCP) for Marfan Syndrome

Nursing Care Plan (NCP) for Mastitis

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Meniere’s Disease

Nursing Care Plan (NCP) for Migraines

Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)

Nursing Care Plan (NCP) for Multiple Sclerosis (MS)

Nursing Care Plan (NCP) for Myasthenia Gravis (MG)

Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida

Nursing Care Plan (NCP) for Neutropenia

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Nutrition Imbalance

Nursing Care Plan (NCP) for Omphalocele

Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease

Nursing Care Plan (NCP) for Osteoporosis

Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)

Nursing Care Plan (NCP) for Ovarian Cancer

Nursing Care Plan (NCP) for Pancreatitis

Nursing Care Plan (NCP) for Paranoid Disorders

Nursing Care Plan (NCP) for Parkinson’s Disease

Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice

Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)

Nursing Care Plan (NCP) for Personality Disorders

Nursing Care Plan (NCP) for Pertussis / Whooping Cough

Nursing Care Plan (NCP) for Polycystic Ovarian Syndrome (PCOS)

Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)

Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)

Nursing Care Plan (NCP) for Pressure Ulcer / Decubitus Ulcer (Pressure Injury)

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan (NCP) for Prostate Cancer

Nursing Care Plan (NCP) for Psoriasis

Nursing Care Plan (NCP) for Pulmonary Embolism

Nursing Care Plan (NCP) for Renal Calculi

Nursing Care Plan (NCP) for Respiratory Failure

Nursing Care Plan (NCP) for Restrictive Lung Diseases

Nursing Care Plan (NCP) for Reye’s Syndrome

Nursing Care Plan (NCP) for Rheumatic Fever

Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)

Nursing Care Plan (NCP) for Risk for Fall

Nursing Care Plan (NCP) for Rubeola – Measles

Nursing Care Plan (NCP) for Schizophrenia

Nursing Care Plan (NCP) for Scoliosis

Nursing Care Plan (NCP) for Seizures

Nursing Care Plan (NCP) for Sepsis

Nursing Care Plan (NCP) for Skin cancer – Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma

Nursing Care Plan (NCP) for Skull Fractures

Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)

Nursing Care Plan (NCP) for Spinal Cord Injury

Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer)

Nursing Care Plan (NCP) for Syncope (Fainting)

Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)

Nursing Care Plan (NCP) for Testicular Cancer

Nursing Care Plan (NCP) for Thoracentesis (Procedure)

Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)

Nursing Care Plan (NCP) for Thyroid Cancer

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

Nursing Care Plan (NCP) for Tuberculosis

Nursing Care Plan for (NCP) Autism Spectrum Disorder

Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)

Nursing Care Plan for Amputation

Nursing Care Plan for Chlamydia (STI)

Nursing Care Plan for Cirrhosis (Liver)

Nursing Care Plan for Compartment Syndrome

Nursing Care Plan for Coronary Artery Disease (CAD)

Nursing Care Plan for Distributive Shock

Nursing Care Plan for Endometriosis

Nursing Care Plan for Fractures

Nursing Care Plan for Gastritis

Nursing Care Plan for Gonorrhea (STI)

Nursing Care Plan for Hemorrhoids

Nursing Care Plan for Herpes Simplex (HSV, STI)

Nursing Care Plan for Liver Cancer

Nursing Care Plan for Macular Degeneration

Nursing Care Plan for Myocarditis

Nursing Care Plan for Osteomyelitis

Nursing Care Plan for Pelvic Inflammatory Disease (PID)

Nursing Care Plan for Pulmonary Edema

Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)

Nursing Care Plan for Scleroderma

Nursing Care Plan for Syphilis (STI)

Nursing Care Plan for Testicular Torsion

Oxytocin (Pitocin) Nursing Considerations

Patient Records and Care Documentation for Certified Perioperative Nurse (CNOR)

Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)