A young woman comes to the mental health clinic for her routine medication follow-up. She has been married for 2 years and reports that she and her husband are ready to start a family. She has a...

A young woman comes to the mental health clinic for her routine medication follow-up. She has been married for 2 years and reports that she and her husband are ready to start a family. She has a diagnosis of bipolar I disorder and has been well managed on divalproex sodium (Depakote) for at least 3 years. What is the most essential counsel for the nurse to give her?

1. “Schedule an appointment for a complete gynecological exam if you have not had one in the past year.”

2. “Pay careful attention to eating healthy from this point on in order to maximize the health of both mother and baby.”

3. “Check with your prescriber today as Depakote carries an increased risk for birth defects, especially during the first 3 months of pregnancy.”

4. “It is very important for you to take steps to reduce your stress and this will help you to stay in balance during your pregnancy and reduce your chances of developing post-partum depression.”