A nurse is caring for a client who has anorexia nervosa and overexercises to avoid gaining weight. Which of the following nursing actions should the nurse take?

Gabapentin and phenytoin are not directly associated with causing vitamin B deficiencies. However, certain antiseizure medications could potentially affect nutrient absorption over time.

B) A client who has chronic alcohol use disorder.

Explanation:

Chronic alcohol use disorder can lead to a deficiency in several B vitamins, particularly vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin), vitamin B6 (pyridoxine), vitamin B9 (folate), and vitamin B12 (cobalamin). Alcohol interferes with the absorption and utilization of these vitamins in the body, and individuals with alcohol use disorder are often at risk for malnutrition and vitamin deficiencies.

C) A client who takes heparin to prevent deep vein thrombosis:

Heparin is an anticoagulant and does not directly impact the absorption or utilization of vitamin B.

D) A client who has asthma:

Asthma itself does not significantly increase the risk of vitamin B deficiencies. Vitamin B deficiencies are more commonly associated with factors like malnutrition, certain medical conditions, or medications that impact absorption, as seen in chronic alcohol use disorder.

Lithium is a commonly used medication for treating bipolar disorder, and therapeutic drug monitoring is crucial to ensure its effectiveness and prevent potential toxicity. Monitoring the client's lithium levels in the blood is important because lithium has a narrow therapeutic range, meaning that levels that are too low might not provide the desired therapeutic effect, while levels that are too high can lead to toxicity.

B) "This medication is addictive, so you will need to discontinue it in six months."

Lithium is not considered addictive. It's important to provide accurate information about the nature of the medication to avoid unnecessary concerns.

C) "Weight gain should be reported to your provider as an indication of lithium toxicity."

While weight gain can be a side effect of some medications, it's not a specific indicator of lithium toxicity. Lithium toxicity is characterized by a range of symptoms including tremors, confusion, nausea, vomiting, and excessive thirst, among others.

D) "Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Diuretics are generally not recommended with lithium because they can increase the risk of lithium toxicity. Lithium can affect kidney function, and using diuretics may exacerbate this effect. The client should be advised not to use diuretics without consulting their healthcare provider.