A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?
0.8 mEq/L
2.3 mEq/L
1.8 mEq/L
1.2 mEq/L
The Correct Answer is B
Choice A Reason: 0.8 mEq/L
The therapeutic range for lithium is typically between 0.6 and 1.2 mEq/L. A level of 0.8 mEq/L falls within this range and is considered normal. Therefore, it is unlikely that a client with this lithium level would present with symptoms such as mental confusion, frequent urination, and coarse tremors. These symptoms are more indicative of lithium toxicity, which occurs at higher levels.
Choice B Reason: 2.3 mEq/L
A lithium level of 2.3 mEq/L is significantly above the therapeutic range and indicates lithium toxicity. Symptoms of lithium toxicity include mental confusion, frequent urination, and coarse tremors, which match the client’s presentation. Severe toxicity can occur at levels above 2.0 mEq/L and can be life-threatening if not treated promptly. Therefore, this is the most likely lithium level for the client described.
Choice C Reason: 1.8 mEq/L
A lithium level of 1.8 mEq/L is above the therapeutic range but below the level typically associated with severe toxicity. While some symptoms of toxicity might appear at this level, they are generally less severe than those described in the scenario. The client’s symptoms suggest a more severe level of toxicity, making this choice less likely.
Choice D Reason: 1.2 mEq/L
A lithium level of 1.2 mEq/L is at the upper limit of the therapeutic range. While it is possible for some mild side effects to occur at this level, the severe symptoms described (mental confusion, frequent urination, and coarse tremors) are more indicative of a higher, toxic level of lithium. Therefore, this choice is also less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
b. Washes their hands before placing the eye drops
d. Puts the drop from inner to outer canthus
Explanation of Choices
Choice A Reason: Puts the Eye Drops in a Room with Low Lighting
Administering eye drops in a room with low lighting is not a recommended practice. Proper lighting is essential to ensure accurate placement of the drops and to avoid contamination or injury. Low lighting can make it difficult to see the eye and the dropper, increasing the risk of improper administration. Therefore, this action does not indicate correct performance of the skill.
Choice B Reason: Washes Their Hands Before Placing the Eye Drops
Washing hands before administering eye drops is a crucial step to prevent infection and contamination. Clean hands reduce the risk of transferring bacteria or other pathogens to the eye, which can cause infections or other complications. This action is a fundamental part of proper eye drop administration and indicates correct performance of the skill.
Choice C Reason: Uses the Patient’s Iris as a Landmark for Direct Placement of the Drop
Using the patient’s iris as a landmark for direct placement of the drop is incorrect. The proper technique involves pulling down the lower eyelid to create a small pocket (conjunctival sac) and placing the drop into this pocket. Directly aiming for the iris can cause discomfort and increase the risk of injury or contamination. Therefore, this action does not indicate correct performance of the skill.
Choice D Reason: Puts the Drop from Inner to Outer Canthus
Placing the drop from the inner to the outer canthus (corner of the eye) is a correct technique. This method helps ensure that the drop spreads evenly across the eye surface and reduces the risk of contamination. It also helps in preventing the dropper from touching the eye or eyelid, which can introduce bacteria. This action indicates correct performance of the skill.
Choice E Reason: Holds the Upper Eyelid Open When Placing the Drop
Holding the upper eyelid open when placing the drop is not the recommended technique. The proper method involves pulling down the lower eyelid to form a pocket and placing the drop into this pocket. Holding the upper eyelid open can cause discomfort and may not allow the drop to be placed accurately. Therefore, this action does not indicate correct performance of the skill.
Correct Answer is B
Explanation
Choice A Reason:
Stable and satisfactory relationships. This statement is incorrect. Individuals with borderline personality disorder (BPD) often struggle with maintaining stable and satisfactory relationships. They may experience intense and unstable relationships characterized by extreme fluctuations between idealization and devaluation of others. This instability is a hallmark of BPD and can lead to significant interpersonal difficulties.
Choice B Reason:
Little tolerance for being alone. This statement is correct. One of the defining characteristics of BPD is a profound fear of abandonment and an intense need for companionship. Individuals with BPD often have little tolerance for being alone and may go to great lengths to avoid real or imagined abandonment. This fear can lead to frantic efforts to maintain relationships, even if they are unhealthy or abusive.
Choice C Reason:
Predictability. This statement is incorrect. People with BPD typically exhibit unpredictable and impulsive behaviors. Their emotional responses can be intense and rapidly changing, making their behavior difficult to predict. This unpredictability can further complicate their relationships and daily functioning.
Choice D Reason:
Controlled anger. This statement is incorrect. Individuals with BPD often struggle with controlling their anger. They may experience intense and inappropriate anger, which can be difficult to manage and may result in aggressive or self-destructive behaviors. This difficulty in controlling anger is another key feature of BPD.
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