Nokea
The nurse is reviewing the medical records of several clients who are receiving lithium. Which of the following would the nurse identify as being at increased risk for the development of lithium toxicity?
- A. Clients receiving furosemide (Lasix)
- B. Clients experiencing diarrhea
- C. Clients with renal insufficiency
- D. Clients with liver cirrhosis
- E. Clients experiencing vomiting
Correct Answer: A,B,C,E
Rationale: Diuretics like furosemide, diarrhea, vomiting, and renal insufficiency increase lithium levels by reducing clearance, heightening toxicity risk.
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A client taking phenelzine (Nardil) is at a dinner party and has several glasses of red wine. The client begins to feel nauseated and develops a terrible headache. The client is taken to the nearest emergency department (ED). This client might be experiencing a hypertensive crisis. What other symptoms might the nurse in the ED assess if the client is experiencing a hypertensive crisis?
- A. Constricted pupils
- B. Chills
- C. Chest pain
- D. Tachycardia
- E. Stiff neck
Correct Answer: C,D,E
Rationale: Hypertensive crisis from MAOI-tyramine interactions may present with chest pain, tachycardia, and stiff neck, among other symptoms.
A client is prescribed a monoamine oxidase inhibitor (MAOI) for depression. During the initial interview, with the client, the nurse understands that the client is also receiving an adrenergic agent. The nurse would be alert for which of the following?
- A. Increased risk for hypertensive episodes
- B. Increased risk for severe convulsions
- C. Increased risk for hyperpyretic episodes
- D. Increased risk for cardiac arrhythmias
Correct Answer: D
Rationale: MAOIs combined with adrenergic agents can lead to cardiac arrhythmias due to excessive catecholamine activity.
A nurse is caring for an older adult client who has been prescribed amoxapine for depression accompanied by anxiety. After administration of the drug, the nurse observes muscle rigidity and sweating. The nurse identifies these as the symptoms of neuroleptic malignant syndrome. Which of the following would the nurse do next?
- A. Suggest the client engage in exercise
- B. Get the client to drink a glass of cold water
- C. Encourage the client to breathe deeply
- D. Stop the drug and contact the physician
Correct Answer: D
Rationale: Neuroleptic malignant syndrome is a medical emergency; stopping the drug and contacting the physician is the appropriate action.
A client is receiving lithium therapy at a health care facility. The client informs the nurse that he is taking antacids for heartburn. The nurse would be alert for which of the following due to the interaction of the two drugs?
- A. Decreased effectiveness of lithium
- B. Increased risk of lithium toxicity
- C. Increased risk for bipolar disorder
- D. Increased psychotic symptoms
Correct Answer: A
Rationale: Antacids can reduce lithium absorption, leading to decreased effectiveness of the drug.
When developing the plan of care for a client who is receiving lithium therapy, which nursing diagnosis would the nurse most likely identify as a priority?
- A. Self-Care Deficit
- B. Disturbed Sleep Pattern
- C. Imbalanced Nutrition: Less Than Body Requirements
- D. Imbalanced Fluid Volume
Correct Answer: D
Rationale: Imbalanced fluid volume is a priority due to lithium's narrow therapeutic index, where fluid status directly impacts toxicity risk.