A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

Eliminate use of nonsteroidal anti-inﬂammatory drugs. (NSAIDs)

Avoid consuming all foods that contain Iodine.

Notify healthcare provider prior to dental procedures.

Monitor blood glucose levels daily.

Answer and Explanation

The Correct Answer is A

Lithium carbonate is a mood stabilizer commonly used to treat bipolar disorder. However, it has a narrow therapeutic index and requires careful monitoring of serum levels to avoid toxicity. One of the major concerns with lithium therapy is the potential for drug interactions and toxicity. NSAIDs such as ibuprofen and naproxen can increase lithium levels by reducing its excretion and can lead to lithium toxicity. Therefore, it is essential to instruct the client to eliminate the use of NSAIDs while taking lithium.

Option b) Avoid consuming all foods that contain iodine is incorrect because iodine is not contraindicated with lithium. However, excessive iodine intake can interfere with thyroid function, which can exacerbate mood instability.

Option c) Notify healthcare provider prior to dental procedures is not specific to lithium therapy and is a general precaution that patients with bipolar disorder should follow before any medical or dental procedures.

Option d) Monitor blood glucose levels daily is also not directly related to lithium therapy. While lithium can cause diabetes insipidus, which can lead to excessive thirst and urination, it does not typically aﬀect blood glucose levels.

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Correct Answer is A

Explanation

Misoprostol should not be used during pregnancy as it can cause harm to the fetus. Women of childbearing potential should use eﬀective contraception while taking misoprostol. If there is a chance of conception, the healthcare provider should be contacted immediately. A negative pregnancy test is required before starting therapy with misoprostol .

A. Replace salt with a salt substitute. B. Limits intake of high-potassium foods. C. Cover your skin before going outside. D. Monitor skin for excessive bruising.

Correct Answer is B

Explanation

Spironolactone is a potassium-sparing diuretic that works by blocking the actions of aldosterone, a hormone that can lead to potassium loss in the urine. However, in some cases, spironolactone can cause hyperkalemia (high levels of potassium in the blood), which can be dangerous for patients with heart failure. Therefore, it is important to instruct the patient to limit their intake of high-potassium foods such as bananas, oranges, tomatoes, spinach, and salt substitutes containing potassium.

Option a (Replace salt with a salt substitute) is incorrect because salt substitutes often contain potassium, which can further increase the risk of hyperkalemia.

Option c (Cover your skin before going outside) is unrelated to the use of spironolactone and hyperkalemia.

Option d (Monitor skin for excessive bruising) is not directly related to the use of spironolactone and hyperkalemia, although it is a potential side eﬀect of other medications used to treat heart failure.

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A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

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Naxlex Comprehensive Predictor Exams

A female client with a history of peptic ulcer disease receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching?

Correct Answer is A

Explanation

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?

Correct Answer is B

Explanation

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