A client who is being treated with lithium carbonate for bipolar disorder type I begins to develop diarrhea, vomiting, and drowsiness. Which action should the registered nurse take?
Select one:
Hold the medication and refuse to administer additional doses for 3 days.
Notify the health care provider immediately and give 4 liters of fluids.
Prior to giving the next dose, notify the health care provider of these symptoms and hold the next dose until new orders from provider.
Document the client's symptoms and continue with medication as prescribed.
The Correct Answer is C
Diarrhea, vomiting, and drowsiness are potential signs of lithium toxicity, which can be a serious and potentially life-threatening condition. If a client who is being treated with lithium carbonate develops these symptoms, the nurse should notify the health care provider immediately and hold the next dose of medication until new orders are received from the provider.
Option a. Hold the medication and refuse to administer additional doses for 3 days is not an appropriate action because it does not involve notifying the health care provider or obtaining new orders.
Option b. Notify the health care provider immediately and give 4 liters of fluids is not an appropriate action because it involves administering fluids without obtaining orders from the health care provider.
Option d. Document the client’s symptoms and continue with medication as prescribed is not an appropriate action because it does not involve notifying the health care provider or holding the next dose of medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Borderline personality disorder is a serious mental illness characterized by instability in mood, behaviour, and self-image. Patients with borderline personality disorder are at a high risk of self-harm, suicide, and impulsive behaviours. Therefore, the nurse's priority assessment should be to identify any suicidal or homicidal ideations, as these can be life-threatening emergencies. Once identified, appropriate interventions should be initiated, such as suicide precautions, crisis management, and referral to mental health professionals for further evaluation and treatment.
While sleep patern changes, impulsive behaviours, and support systems are also important aspects to assess in patients with borderline personality disorder, they are not the priority when compared to suicidal or homicidal ideations.
Correct Answer is D
Explanation
If the nurse has concerns about the prescribed dose of an antianxiety medication being higher than the usual adult dose, they should hold the medication and consult with the health care provider before administering it. This will allow the health care provider to review the prescription and make any necessary adjustments to ensure the safety and well-being of the patient.
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