In the case of a misdiagnosed bipolar disorder patient started on an antidepressant, what major risk should a nurse monitor for?

When a patient with undiagnosed or misdiagnosed bipolar disorder is started on an antidepressant, there is a significant risk of activating a manic episode. Antidepressants can sometimes lead to a switch from a depressive state to mania in individuals with bipolar disorder, particularly if the mood disorder is not properly managed or recognized. This activation of mania can exacerbate existing symptoms, including increased agitation, impulsivity, and risk-taking behavior, which can heighten the risk of suicidality.

Monitoring for indications of mania is essential, as these symptoms may emerge rapidly, and the management plan may need to be adjusted to prevent potential harm to the patient. The focus on suicidality is particularly critical because a manic phase, combined with underlying depressive episodes, can increase the risk of suicidal thoughts and actions, making it imperative for healthcare providers to closely observe mood changes and behavior in these patients.

The other options, while they may be relevant in different contexts, are less specific to the risks associated with initiating antidepressant therapy in a patient who has not been correctly diagnosed with bipolar disorder. For instance, the development of psychotic symptoms, severe headache, or serotonin syndrome may occur under other circumstances, but they do not capture the immediate and critical concern of manic activation