A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months. The client has a temperature of 39.5* C (103.4° F), blood pressure of 150/110 mm Hg, and muscle rigidity. Which of the following complications should the nurse suspect?

A. Prepare for gastric lavage due to an extremely elevated lithium level.

This option is incorrect. A lithium level of 1.0 mEq/L is within the therapeutic range for treating bipolar disorder or other mood disorders. Gastric lavage (stomach pumping) is not indicated for this level of lithium concentration.

B. Check the client's medication record to assess whether the client has been refusing her lithium.

This option is not directly relevant to the client's current lithium level of 1.0 mEq/L. While it's important to monitor medication adherence, the client's lithium level is within the therapeutic range, so there is no immediate concern about refusal or non-adherence.

C. Administer the morning dose of lithium.

This option is correct. With a lithium level of 1.0 mEq/L, which falls within the therapeutic range for treating bipolar disorder, the nurse should proceed with administering the morning dose of lithium as prescribed. It's important to maintain therapeutic lithium levels to effectively manage the client's condition.

D. Hold the medication and assess for early manifestations of toxicity.

This option is incorrect. With a lithium level of 1.0 mEq/L, there is no indication to hold the medication or suspect early manifestations of toxicity. Monitoring for lithium toxicity is important, but it's not warranted in this scenario where the lithium level is within the therapeutic range.

Fluid excess, also known as fluid overload or hypervolemia, occurs when there is an excessive volume of fluid in the body. The nurse should assess for signs and symptoms of fluid excess, which include the following:

A. Bounding pulse: A bounding pulse, or a pulse that feels unusually strong and forceful, can be a sign of fluid excess. Increased blood volume leads to increased cardiac output, which can manifest as a bounding pulse.

B. Urine-specific gravity greater than 1.030: Urine-specific gravity greater than 1.030 typically indicates concentrated urine and is more indicative of dehydration rather than fluid excess.

C. Pitting edema: Pitting edema occurs when pressure is applied to the skin, resulting in an indentation or "pit" that persists after the pressure is released. It is a classic sign of fluid excess, indicating fluid accumulation in the interstitial spaces.

D. Swelling at the IV site: Swelling at the IV site may indicate infiltration or phlebitis rather than fluid excess. While fluid excess can lead to generalized swelling, swelling specifically at the IV site may suggest a local issue related to the IV infusion.

E. Crackles upon auscultation: Crackles, also known as rales, are abnormal lung sounds heard upon auscultation and are indicative of fluid accumulation in the lungs, which can occur with fluid excess. Crackles are typically heard in the bases of the lungs and may indicate pulmonary edema.