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A client asks the nurse if he needs to alter any of his activities because he is taking lithium carbonate. Which of the following responses would be most appropriate?
- A. Increase your salt intake if an activity causes you to perspire heavily.
- B. Wear sunscreen when you are going to be outdoors in the summer time.
- C. Drink less fluid than usual now because you are taking this drug.
- D. No changes are necessary for strenuous activities you do outdoors.
Correct Answer: A
Rationale: Lithium levels can increase to toxic levels with dehydration from heavy perspiration, as sodium loss affects lithium excretion. Increasing salt intake (A) during such activities helps maintain safe lithium levels. Sunscreen (B) is unrelated, reducing fluid (C) risks toxicity, and no changes (D) ignores the risk of dehydration.
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A client with bipolar disorder has had a history of multiple episodes and states, I?m so frustrated with what?s happened because of these episodes. Which of the following would the nurse encourage to help support this client?s recovery?
- A. Codependence
- B. Hope
- C. Self-control
- D. Independent decision making
Correct Answer: B
Rationale: Encouraging hope (B) fosters resilience and motivation for recovery in bipolar disorder, countering frustration. Codependence (A) is unhealthy, self-control (C) is important but less primary, and independent decision-making (D) may be impaired during episodes.
A nurse is preparing to administer medications to a female client with bipolar disorder who is experiencing acute mania. Which of the following would be most appropriate for the nurse to do?
- A. Tell the client firmly that she must take her medication.
- B. Allow the client to participate in the treatment decision.
- C. Restrain the client before administering the medication.
- D. Notify the physician about the client?s refusal of the medication.
Correct Answer: B
Rationale: Allowing the client to participate in treatment decisions (B) fosters autonomy and therapeutic alliance, appropriate unless the client is too impaired to decide. Firm insistence (A) may escalate agitation, restraint (C) is a last resort, and notifying the physician (D) assumes refusal prematurely.
A client with bipolar disorder has a lithium drug level of 1.2 mEq/L. Which of the following would the nurse expect to assess? Select all that apply.
- A. Metallic taste
- B. Ataxia
- C. Diarrhea
- D. Slurred speech
- E. Fasciculations
- F. Muscle weakness
Correct Answer: A,C,F
Rationale: A lithium level of 1.2 mEq/L is within the therapeutic range (0.6?1.2 mEq/L) but at the upper limit, where mild side effects like metallic taste (A), diarrhea (C), and muscle weakness (F) may occur. Ataxia (B), slurred speech (D), and fasciculations (E) are more typical of toxicity (>1.5 mEq/L).
A client diagnosed with bipolar disorder and experiencing mania is admitted to the inpatient psychiatric setting. During the acute phase of mania, which medication would the nurse expect to most likely administer?
- A. Lithium carbonate (Lithium)
- B. Haloperidol lactate (Haldol)
- C. Fluoxetine (Prozac)
- D. Paroxetine (Paxil)
Correct Answer: B
Rationale: Haloperidol (B), a typical antipsychotic, is commonly used in acute mania to rapidly control severe agitation, impulsivity, and psychotic symptoms due to its fast-acting nature. Lithium (A) is effective for long-term mood stabilization but slower in acute mania. Fluoxetine (C) and paroxetine (D), SSRIs, are used for depression, not mania, and may worsen manic symptoms.
A client with bipolar disorder having experienced a depressive episode is prescribed lamotrigine. After teaching the client about this medication, the nurse determines that the teaching was successful when the client states which of the following?
- A. I need to notify my physician if I develop a skin rash.
- B. I need to have my blood tested about once a month.
- C. I need to watch how much salt I use every day.
- D. This drug can affect my liver function.
Correct Answer: A
Rationale: Lamotrigine (A) carries a risk of serious skin rashes, such as Stevens-Johnson syndrome, requiring immediate reporting. Blood testing (B) is not routine for lamotrigine, salt intake (C) is irrelevant, and liver function (D) is less commonly affected compared to other mood stabilizers.