A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?

A. Akathisia: Akathisia is characterized by restlessness and an inability to sit still. While it can be a side effect of antipsychotic medications like haloperidol, it does not present with fever, hypertension, and muscle rigidity, as described in the scenario.

B. Neuroleptic malignant syndrome (NMS): NMS is a potentially life-threatening condition associated with antipsychotic medications like haloperidol. It is characterized by hyperthermia, autonomic dysfunction (e.g., hypertension), altered mental status, and severe muscle rigidity. The client's symptoms of fever, elevated blood pressure, and muscle rigidity are consistent with NMS.

C. Tardive dyskinesia: Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face, tongue, and other body parts. It is a long-term side effect of antipsychotic medications and typically develops after prolonged use, unlike the acute onset seen in the scenario.

D. Agranulocytosis: Agranulocytosis is a rare but serious side effect of antipsychotic medications, characterized by a severe reduction in white blood cell count, leading to an increased risk of infection. The symptoms described in the scenario are not consistent with agranulocytosis.

A. The client drinks 2 liters of liquids daily. - This statement indicates adequate fluid intake, which is important for preventing dehydration and lithium toxicity. Increased fluid intake helps maintain normal lithium levels by promoting its excretion through urine.

B. The client eats 2 to 3 gm of sodium-containing foods daily. - This statement suggests a moderate sodium intake, which can help maintain stable lithium levels. Adequate sodium intake is important for preventing lithium toxicity because sodium depletion can increase lithium reabsorption by the kidneys, leading to higher serum levels.

C. The client runs 4 miles outdoors every afternoon. - This statement indicates excessive sweating, which can lead to dehydration and subsequent lithium toxicity. Vigorous exercise, particularly in hot environments, increases fluid loss through sweating, potentially reducing lithium excretion and increasing serum levels.

D. The client eats foods high in tyramine. - This statement is unrelated to lithium toxicity. Tyramine-containing foods are typically associated with interactions with monoamine oxidase inhibitors (MAOIs), not lithium.