Which of the following should be monitored in clients taking valproic acid?

• A. Hepatic function
• B. Renal function
• C. Thyroid function
• D. Bone density

Answer: (A)

Valproic acid can cause hepatotoxicity, including potentially serious or fatal liver injury, especially in the early months of therapy. Because of this risk, hepatic function should be checked before starting treatment and monitored regularly after initiation, with liver enzymes (AST/ALT), bilirubin, and other markers as indicated. Clinicians also watch for signs of liver trouble—unexplained fatigue, jaundice, dark urine, pale stools, persistent nausea or vomiting, or right upper quadrant pain—and would repeat tests promptly if these occur. Renal function, thyroid function, and bone density are not the primary monitoring priorities for valproic acid, though they may be relevant for other conditions or medications.