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A client with bipolar disorder has been taking lithium, and today his serum blood level is 1.8 mEq/L. The client reports nausea. Which of the following interventions by the nurse is indicated?
- A. Constipation and postural hypotension
- B. Fever, muscle rigidity
- C. Nausea
- D. None, the serum level is in therapeutic range
Correct Answer: C
Rationale: A lithium level of 1.8 mEq/L is above the therapeutic range (0.5-1.5 mEq/L) and indicates potential toxicity, with nausea being a common symptom. The nurse should notify the physician for further evaluation.
You may also like to solve these questions
The nurse is preparing a patient for an MRI scan of the head. The nurse should ask the patient.
- A. Have you ever had an allergic reaction to radioactive dye?
- B. Have you had anything to eat in the last 24 hours?
- C. Does your insurance cover the cost of this scan?
- D. Are you anxious about being in tight spaces?
Correct Answer: D
Rationale: The person undergoing an MRI must lie in a small, closed chamber and remain motionless during the procedure, which takes about 45 minutes. Those who feel claustrophobic or have increased anxiety may require sedation before the procedure. PET scans, not MRIs, require radioactive substances. Fasting is not required for brain imaging studies, and verifying insurance is not a primary nursing role.
One week after beginning therapy with thiothixene (Navane), the client demonstrates muscle rigidity, a temperature of 39.5?°C, and altered mental status. The nurse should notify the physician because these symptoms are indicative of
- A. Acute dystonia
- B. Extrapyramidal side effects
- C. Neuroleptic malignant syndrome
- D. Tardive dyskinesia
Correct Answer: C
Rationale: These symptoms "muscle rigidity, high fever, and altered mental status "are classic signs of neuroleptic malignant syndrome, a potentially fatal reaction requiring immediate medical attention.
Which of the following side effects of lithium are frequent causes of noncompliance?
- A. Metallic taste in the mouth
- B. Weight gain
- C. Acne
- D. Thirst
- E. Lethargy
Correct Answer: B,E
Rationale: Lethargy and weight gain are difficult to manage and frequently lead to noncompliance with lithium therapy.
A patient with bipolar disorder takes lithium 300 mg three times daily. The nurse evaluates that the dose is appropriate when the patient reports
- A. Feeling sleepy and less energetic.
- B. Weight gain of 7 pounds in the last month.
- C. Minimum mood swings.
- D. Increased feelings of self-worth.
Correct Answer: C
Rationale: Mood-stabilizing drugs like lithium aim to minimize mood swings in bipolar disorder. Weight gain and lethargy may occur but are not indicators of appropriate dosing, and inflated self-worth is a symptom that should diminish with treatment.
Which of the following medications rarely causes extrapyramidal side effects (EPS)?
- A. Ziprasidone (Geodon)
- B. Chlorpromazine (Thorazine)
- C. Haloperidol (Haldol)
- D. Fluphenazine (Prolixin)
Correct Answer: A
Rationale: Atypical antipsychotics like ziprasidone rarely cause EPS compared to first-generation antipsychotics like chlorpromazine, haloperidol, and fluphenazine.