A client has a blood alcohol level that is double the legal limit for driving yet does not exhibit behaviors of intoxication. The nurse knows that this is due to which effect?

A. Pharmacotherapy: While medication is crucial in managing bipolar disorder, the immediate priority during a manic episode is ensuring the client's safety, as they may engage in risky behavior.

B. Client safety: Client safety is the highest priority during a manic episode, as clients may act impulsively, which can lead to harm to themselves or others.

C. Cognitive-behavioral therapy: CBT is an important therapeutic intervention for long-term management, but it is not the immediate priority during a manic episode.

D. Distraction therapy: Distraction techniques can be helpful, but they are not a priority compared to ensuring the client’s safety.

A. Instruct to resume regular activities such as driving. It is not safe to instruct the client to resume activities like driving immediately, especially at the beginning of lithium therapy, as lithium can cause side effects that may impair the client's ability to safely perform tasks such as driving.

B. Administer lithium before meals. Lithium is typically taken with food to minimize gastrointestinal upset. Administering it before meals may increase the risk of side effects like nausea.

C. Withhold if serum level is less than 1.5 mEq. Lithium should be withheld if the serum level is above the therapeutic range (typically 0.6–1.2 mEq/L), as higher levels can lead to toxicity. Withholding lithium if the level is less than 1.5 mEq/L is incorrect and could lead to inadequate treatment.

D. Instruct to avoid breastfeeding. Lithium is excreted in breast milk and can pose a risk to the infant, so the client should be advised against breastfeeding while on lithium therapy.