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# Psychotropic medicines: what the nurse assesses, monitors and teaches (no doses)

- Safe practice

Before and after each psychotropic medicine, the nurse asks how the person feels, looks for side effects, checks the ordered tests and teaches.

Updated Nov 13, 2026

## Key points

- Assess subjectively before and after: «Tell me how you are feeling today» tells you more about an antidepressant than a blood pressure reading.
- Review every medicine, including over-the-counter and herbal products, and medicines that can themselves cause psychiatric symptoms.
- Check the ordered laboratory results (drug levels, electrolytes, organ function) before giving the medicine, and report values out of range.
- Watch for «cheeking» (medicine kept in the mouth and not swallowed) and tell the team.
- Teach the purpose, expected effect and its timing, side effects, how to cope with temporary ones and why not to stop suddenly.
- In Colombia, controlled medicines (purple band, «franja violeta») follow Res. 1478 de 2006 and the institutional protocol for custody and records.

## What it is

Psychotropic medicines act on the mind, emotions and behaviour. The nurse cannot measure a neurotransmitter, so the effect is judged mostly through talk and observation: mood, sleep, thinking, behaviour and movement. The nurse also reviews the medicine list, the laboratory results the prescriber ordered, adherence and its barriers, and teaches the person and family. Many psychotropics are «medicamentos de control especial» in Colombia, with their own custody and records. Doses come from the prescription and a current drug reference, never from this page.

## What it requires

- A current drug reference consulted before giving any psychotropic: drug information changes often.
- The prescription, the medicine list reconciled on admission and the ordered laboratory schedule.
- Baseline data: mood, sleep, appetite, weight, vital signs and movements, so later changes can be compared.
- The institutional route for reporting suspected adverse reactions to the farmacovigilancia programme (INVIMA).

## Components

- Assessment: symptoms, effect, side effects, adherence and barriers (cost, stigma, mistrust of the health team).
- Monitoring: vital signs, weight, movements, laboratory results and drug levels as ordered.
- Safe administration: the rights of medication administration, swallowing checked, controlled-drug records.
- Teaching and follow-up with the person and family, including the option to discuss alternatives with the prescriber.

## How it is applied (and why)

- Ask how the person feels and observe mood, speech, thinking and movement before each dose — this is how a psychotropic's effect is judged.
- Reconcile all medicines, including non-prescription and herbal products — interactions and drug-caused psychiatric symptoms are common.
- Check the laboratory results and drug levels ordered for that medicine before giving it — some psychotropics are toxic close to the useful level.
- Give the medicine with the rights of administration and stay until it is swallowed — cheeking leads to hoarding or missed treatment.
- Look for new or worse side effects and new behaviour (agitation, mood change, suicidal thoughts) and report them — some are emergencies.
- Teach purpose, timing of the effect and side effects in plain words, with the family when the person agrees — understanding supports adherence.
- Ask about barriers to taking the medicine at home and plan with the team and social work — cost, distance or stigma stop treatment.
- Record and report suspected adverse reactions through the institutional farmacovigilancia programme — reports feed national drug safety.

## In nursing practice

- A person who stops a psychotropic suddenly may have withdrawal symptoms or a relapse: ask about missed doses.
- Older adults are more sensitive to sedation, dizziness and anticholinergic effects: assess fall risk.
- Pregnancy or breastfeeding changes the choice of medicine: report it to the prescriber (see perinatal mental health).
- People without a stable home may lose medicines or prescriptions: link them with community follow-up.

## Common mistakes

- Judging the effect only by vital signs and not asking how the person feels.
- Giving the medicine without checking the ordered drug level or laboratory result.
- Leaving before the person swallows the medicine.
- Teaching once at discharge instead of during the whole stay.

## Test yourself

Think of the answer, then tap the question to see it.

## How does the nurse mainly judge whether an antidepressant is working?

Through subjective assessment: asking how the person feels and observing mood, sleep, speech, thinking and behaviour over time.

## What is «cheeking» and why does it matter?

Keeping the medicine in the mouth without swallowing it. It leads to missed treatment or hoarded medicine, so the nurse watches for it and tells the team.

## What should the nurse check before giving a psychotropic that needs blood levels?

The ordered drug level and laboratory results; a value out of range is reported to the prescriber before the dose.

## Which Colombian rule governs medicines with the purple band («franja violeta»)?

Resolución 1478 de 2006 on controlled substances and «medicamentos de control especial», applied through the institutional protocol.

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## Elsewhere in DurgiPedia

- [Adherence: what it is and why it fails](https://durgical.com/en/behavioral-science/adherence-what-it-is-and-why-it-fails/)

## Connections

## Related 6

- [The rights of medication administration](https://durgical.com/en/nursing/the-rights-of-medication-administration/)
- [Medication reconciliation](https://durgical.com/en/nursing/medication-reconciliation/)
- [Pharmacovigilance and technovigilance: what nurses report](https://durgical.com/en/nursing/pharmacovigilance-and-technovigilance-what-nurses-report/)
- [Patient education and teach-back](https://durgical.com/en/nursing/patient-education-and-teach-back/)
- [Perinatal mental health: screening, baby blues, depression and psychosis, and when to call](https://durgical.com/en/nursing/perinatal-mental-health-screening-baby-blues-depression-and-psychosis-and-when-t/)
- [People who live on the street (habitantes de calle): health risks and how to reach them](https://durgical.com/en/nursing/people-who-live-on-the-street-health-risks-and-how-to-reach-them/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Nursing: Mental Health and Community Concepts, 11.4: Applying the nursing process to schizophrenia](https://med.libretexts.org/Bookshelves/Nursing/Nursing%3A_Mental_Health_and_Community_Concepts_(OpenRN)/11%3A_Psychosis_and_Schizophrenia/11.04%3A_Applying_the_Nursing_Process_to_Schizophrenia) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2022); [Nursing: Mental Health and Community Concepts, 4.5: Assessment](https://med.libretexts.org/Bookshelves/Nursing/Nursing%3A_Mental_Health_and_Community_Concepts_(OpenRN)/04%3A_Application_of_the_Nursing_Process_to_Mental_Health_Care/4.05%3A_Assessment) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2022); [Nursing: Mental Health and Community Concepts, 4.9: Implementation](https://med.libretexts.org/Bookshelves/Nursing/Nursing%3A_Mental_Health_and_Community_Concepts_(OpenRN)/04%3A_Application_of_the_Nursing_Process_to_Mental_Health_Care/4.09%3A_Implementation) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2022); [Resolución 1478 de 2006: control, seguimiento y vigilancia de sustancias sometidas a fiscalización y medicamentos de control especial](https://www.invima.gov.co/invima_website/static/attachments/normatividad_normatividad_interna/resolucion_20001478_20de_202006_1.pdf) (Ministerio de la Protección Social, Colombia (texto alojado por el INVIMA), 2006); [Vigilancia de medicamentos: Programa Nacional de Farmacovigilancia](https://www.invima.gov.co/productos-vigilados/medicamentos-y-productos-biologicos/vigilancia-sqb) (INVIMA, Colombia, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/nursing/psychotropic-medicines-what-the-nurse-assesses-monitors-and-teaches/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/psychotropic-medicines-what-the-nurse-assesses-monitors-and-teaches/