A home health nurse has a patient who is taking lithium. What should be included in the teaching plan?
Take her blood pressure twice a day to check for hypertension.
Have her drug blood level checked every month.
Avoid aged cheese and red wine.
Examine her skin closely for eruptions.
The Correct Answer is B
A. Take her blood pressure twice a day to check for hypertension. Lithium does not typically cause hypertension. Monitoring blood pressure is not a primary concern for patients on lithium.
B. Have her drug blood level checked every month. Regular monitoring of lithium blood levels is crucial to ensure therapeutic levels and avoid toxicity. Lithium has a narrow therapeutic window, and frequent monitoring helps in adjusting the dose to maintain safe and effective levels.
C. Avoid aged cheese and red wine. This advice is relevant for patients taking MAOIs, not lithium. There is no need for patients on lithium to avoid these foods specifically.
D. Examine her skin closely for eruptions. While skin eruptions can be a side effect of some medications, it is not a primary concern for patients on lithium. The focus should be on monitoring for signs of lithium toxicity and other common side effects like tremors, thyroid dysfunction, and renal impairment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Use nightlights and remove extra furniture from the room: Nightlights provide gentle lighting that can reduce disorientation, and removing extra furniture minimizes fall risk.
B. Place the patient in a room with another recovering patient. This might increase agitation and disrupt both patients' sleep.
C. Instruct the patient to orient himself to his surroundings at bedtime. This may not be effective due to the patient's disorientation during detoxification.
D. Wake the patient up every 4 hours to eat a small snack. Frequent waking can disrupt sleep patterns and increase confusion.
Correct Answer is A
Explanation
A. Anxiety related to uncertainty of the events of the test: Addressing the patient's anxiety and providing information about the procedure can help reduce fear and improve cooperation.
B. Deficient knowledge related to lack of information regarding the procedure: While providing information is important, the immediate emotional response (anxiety) takes priority as it can impact the patient's experience of the procedure.
C. Disturbed thought process related to confusion: While disturbed thought processes are relevant, they are not the primary concern pre-procedure.
D. Disturbed thought process related to temporary memory loss: Temporary memory loss can occur post-ECT, but addressing pre-procedure anxiety is a more immediate priority.
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