A health teaching plan for a patient taking lithium should include instructions to

drink twice the usual dally amount of fluid.

double the lithium dose if diarrhea or vomiting occurs.

maintain normal salt and fluids in the diet.

avoid eating aged cheese, processed meats, and red wine.

Answer and Explanation

The Correct Answer is C

A. Patients do not need to double fluid intake, just maintain adequate hydration (2–3 L/day). Drinking twice the usual amount could lead to fluid overload or dilute sodium balance.

B. Lithium should never be doubled. In fact, vomiting and diarrhea increase risk of lithium toxicity, so the provider must be notified instead.

C. Lithium excretion is closely tied to sodium and fluid balance. A stable diet with normal salt and adequate fluid intake helps prevent fluctuations in lithium levels and reduces risk of toxicity.

D. Avoiding aged cheese, processed meats, and red wine is teaching for MAOI therapy (to prevent hypertensive crisis due to tyramine), not for lithium.

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Correct Answer is A

Explanation

A. Lorazepam is a benzodiazepine that acts quickly to relieve acute anxiety, making it the medication of choice for sudden episodes of severe anxiety.

B. Amitriptyline is a tricyclic antidepressant used for long-term management of depression and anxiety, not for rapid relief of acute anxiety.

C. Buspirone is an anxiolytic effective for chronic anxiety but has a delayed onset of action and is not effective for sudden episodes.

D. Desipramine is a tricyclic antidepressant primarily used for depression and certain chronic anxiety disorders, not for immediate relief of severe anxiety.

A. is attempting to obtain attention by manipulating staff. B. has symptoms of alcohol withdrawal delirium. C. may have sustained a head injury before admission. D. is having an acute psychosis.

Correct Answer is B

Explanation

A. The patient’s symptoms are physiological and neurological, not intentional behaviors for attention.

B. Alcohol withdrawal delirium (delirium tremens) typically occurs 48–72 hours after the last drink and includes tremors, agitation, anxiety, diaphoresis, tachycardia, hallucinations, and nightmares—all present in this patient.

C. Although head injury can cause confusion and agitation, the timing of symptoms following alcohol withdrawal aligns more closely with delirium tremens.

D. Acute psychosis can present with hallucinations, but in this case, the onset following alcohol cessation and accompanying autonomic hyperactivity point toward alcohol withdrawal delirium.

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