A client admitted with a diagnosis of schizoaffective disorder, manic phase, who is currently taking fluoxetine, valproic acid, and olanzapine as prescribed has had an increase in manic symptoms in...

A client admitted with a diagnosis of schizoaffective disorder, manic phase, who is currently taking fluoxetine, valproic acid, and olanzapine as prescribed has had an increase in manic symptoms in the past week. The psychiatrist prescribes a valproic acid blood level to be drawn at once. The nurse understands the rationale for this prescription as which of the following?

1. All clients taking valproic acid need periodic valproic acid levels drawn.

2. Fluoxetine can decrease the effectiveness of the valproic acid.

3. A decrease in the level of valproic acid could explain the increase in manic symptoms.

4. The valproic acid level is needed before a short course of lorazepam for agitation can be prescribed