A nurse in a community mental health clinic is assessing a client who began taking lithium carbonate 5 days ago. The client reports fine hand tremors and has a current lithium level of 1.2 mEq/L. Which of the following actions should the nurse take?

Instruct the client to consume a low-sodium diet to decrease hand tremors.

Teach the client to take the lithium in a single daily dose

Contact the provider for a possible decrease in the lithium dosage.

Encourage the client to take naproxen sodium to decrease tremors.

Answer and Explanation

The Correct Answer is C

A. Instruct the client to consume a low-sodium diet to decrease hand tremors:
While maintaining a stable sodium intake is important for individuals taking lithium to avoid fluctuations in lithium levels, a low-sodium diet is not specifically indicated to address hand tremors caused by lithium. Adjusting sodium levels is more about maintaining a consistent intake to stabilize lithium levels over time.

B. Teach the client to take the lithium in a single daily dose:
Lithium is often prescribed in divided doses to maintain stable blood levels throughout the day and minimize side effects. However, the dosing regimen (once or multiple times a day) is usually determined by the healthcare provider based on the individual's needs. Changing the dosing frequency is not the primary intervention for managing hand tremors.

C. Contact the provider for a possible decrease in the lithium dosage:
Hand tremors are a common side effect of lithium. If a client is experiencing bothersome side effects within the therapeutic range, the appropriate action is to contact the healthcare provider. The provider can assess the situation, possibly adjust the dosage, or explore other management options to alleviate the tremors while maintaining the therapeutic effect of the medication.

D. Encourage the client to take naproxen sodium to decrease tremors:
Encouraging the client to take naproxen sodium or any other nonsteroidal anti-inflammatory drug (NSAID) is not recommended when the client is on lithium therapy. NSAIDs can interact with lithium, potentially leading to increased lithium levels and toxicity. Combining these medications should be avoided.

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Correct Answer is B

Explanation

A. "You should leave your partner if you feel your life is in danger."
While leaving an abusive relationship is often necessary for safety, this statement might oversimplify a complex situation. Safety planning should be individualized and may involve various steps, not just immediate departure.

B. "You do not deserve to live in fear of your partner."
This statement validates the client's feelings and emphasizes their right to live without fear. It empowers the client and encourages self-worth.

C. "You need to tell your partner that you intend to leave the relationship."
Telling an abusive partner about the intention to leave can escalate the situation and put the client at risk. Safety planning usually involves not disclosing plans until the client is in a safe environment.

D. "It is important to learn to diffuse your partner's anger."
This statement places the responsibility for the abusive behavior on the victim, which is not appropriate. Victims of abuse are not responsible for the actions of their abusers. The focus should be on their safety and well-being.

A. A family member of the client B. A translator of the same gender as the client C. A unit secretary who speaks the same language as the client D. Another client who speaks the same language as the client

Correct Answer is B

Explanation

A. A family member of the client:
Using a family member might seem like a natural choice, but it could lead to issues of confidentiality, especially if the client does not want their family to know about their situation. Moreover, there could be bias or hesitancy to discuss certain matters in the presence of a family member.

B. A translator of the same gender as the client:
This choice is ideal because individuals might feel more comfortable discussing personal and sensitive topics with someone of the same gender due to cultural or personal reasons. This can foster trust and open communication, crucial in support groups addressing sensitive matters like substance use disorders.

C. A unit secretary who speaks the same language as the client:
While this person might be fluent in the language, their role as a unit secretary might create discomfort for the client. They may not feel as at ease discussing personal issues with someone in a different professional role, even if they share the same language.

D. Another client who speaks the same language as the client:
While peer support can be beneficial, using another client as a translator can compromise the confidentiality and professionalism of the support group. It’s important to maintain boundaries and ensure that communication is facilitated by a professional translator or staff member, especially in sensitive and confidential settings like therapy or support groups.

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A nurse in a community mental health clinic is assessing a client who began taking lithium carbonate 5 days ago. The client reports fine hand tremors and has a current lithium level of 1.2 mEq/L. Which of the following actions should the nurse take?

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