A nurse accidently administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take?

A. "Rinse your child's mouth following administration." - This is important advice to prevent the development of oral thrush (a fungal infection) and to reduce the risk of irritation in the mouth and throat caused by the medication. After using a fluticasone inhaler, rinsing the mouth with water can help prevent these side effects.

C. "Shake the device prior to administration." - Shaking the inhaler before use ensures proper mixing of the medication and enhances its effectiveness.

D. "A spacer will make it easier to use the device." - A spacer is a device that attaches to the inhaler and helps the medication get into the lungs more effectively, especially for children who might have difficulty coordinating the timing of inhalation with activating the inhaler.

The other options:

B. "Have your child take one inhalation as needed for shortness of breath." - This instruction might not be accurate, as fluticasone is usually used as a maintenance medication to control chronic conditions like asthma. It's not typically used as a rescue inhaler for immediate shortness of breath.

E. "Soak the inhaler in water after use." - Soaking the inhaler in water after use is not a standard practice and is not necessary for proper administration or maintenance.

A. Hypomagnesemia:
Correct Answer: This electrolyte imbalance is the one the nurse should assess the client for.
Explanation: Lithium is primarily excreted by the kidneys, and its excretion can be influenced by factors that affect renal function, including electrolyte imbalances. Hypomagnesemia (low magnesium levels) can potentially reduce the excretion of lithium, leading to increased lithium levels in the blood. This can increase the risk of lithium toxicity, which can be dangerous. Therefore, monitoring magnesium levels is important in clients taking lithium.
B. Hyponatremia:
Incorrect Explanation: While hyponatremia (low sodium levels) is a potential concern, it is not as directly linked to lithium interaction as hypomagnesemia.
Explanation: Lithium can cause diabetes insipidus, which leads to excessive urination and subsequent loss of water and electrolytes, including sodium. However, hyponatremia is not the immediate electrolyte imbalance that arises due to the interaction with lithium.
C. Hypocalcemia:
Incorrect Explanation: Hypocalcemia (low calcium levels) is not a primary concern in the context of lithium use.
Explanation: Lithium does not have a direct interaction with calcium levels. Hypocalcemia is typically not a result of lithium use or its interaction with other factors.
D. Hypokalemia:
Incorrect Explanation: While electrolyte imbalances like hypokalemia (low potassium levels) can have health implications, it is not the primary electrolyte imbalance to be concerned about with lithium use.
Explanation: Hypokalemia is not a direct consequence of lithium interaction. Monitoring potassium levels is important for overall health, but it's not the primary electrolyte imbalance associated with lithium use and its potential interactions.