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 ["B","C","F","I"]

Explanation

A. Blood pressure – Within normal range (115/76 mm Hg). No immediate concern.
B. Lithium level – 1.7 mEq/L is above the therapeutic range (0.8–1.2). Toxicity is likely, especially with the client’s symptoms (tremor, confusion, GI upset). Requires urgent follow-up.
C. Sodium level – 128 mEq/L indicates hyponatremia. Low sodium increases the risk for lithium toxicity because lithium and sodium compete for renal reabsorption.
D. WBC count – Within normal range (7,000/mm³).
E. TSH level – Mildly elevated (6). Suggests hypothyroidism (a side effect of lithium) but not immediately life-threatening. Requires follow-up, but not urgent.
F. BUN level –Elevated at 30 mg/dL (normal 10–20). Indicates impaired renal function, which reduces lithium clearance and increases toxicity risk.
G. Levothyroxine dosage – No immediate safety issue noted; managed long term.
H. Acetaminophen – Daily 325 mg is safe; not a concern.
I. Lithium dosage – Current dose (600 mg BID) is likely contributing to toxicity and must be reassessed immediately.

A. buspirone B. lithium C. imipramine D. risperidone

Correct Answer is C

Explanation

A. Buspirone – This anxiolytic does not typically cause significant anticholinergic effects.

B. Lithium – Common side effects include tremor, polyuria, and mild gastrointestinal upset, not prominent anticholinergic effects.

C. Imipramine, a tricyclic antidepressant, has strong anticholinergic properties, leading to dry mouth, blurred vision, mydriasis, constipation, and urinary retention.

D. Risperidone – An atypical antipsychotic; anticholinergic effects are minimal compared to tricyclic antidepressants.

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

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