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?
Brain natriuretic peptide
Erythrocyte sedimentation rate
Thyroid hormone assay
Liver function tests
The Correct Answer is C
A. Brain natriuretic peptide - Brain natriuretic peptide (BNP) is primarily used to diagnose heart failure and assess its severity. It is not routinely monitored in clients taking lithium.
B. Erythrocyte sedimentation rate - Erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not specifically related to lithium therapy monitoring.
C. Thyroid hormone assay - Monitoring thyroid function is essential in clients taking lithium because lithium can affect thyroid function, leading to hypothyroidism or hyperthyroidism. Therefore, checking thyroid hormone levels (T3, T4, and TSH) is important before administering lithium.
D. Liver function tests - While lithium can affect liver function in some cases, routine monitoring of liver function tests is not typically required for clients taking lithium. However, periodic liver function tests may be ordered if clinically indicated or if the client has underlying liver disease.
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Related Questions
Correct Answer is D
Explanation
A. "You will need to take this medication on an empty stomach."
Lithium is typically taken with food to minimize gastrointestinal side effects. Instructing the client to take it on an empty stomach would be incorrect.
B. "You will need to stop this medication if you experience diarrhea."
Diarrhea is not typically a reason to stop lithium therapy. However, persistent diarrhea can lead to dehydration and electrolyte imbalances, which may affect lithium levels. It's essential for the client to report persistent diarrhea to their healthcare provider for further evaluation and management.
C. "You will need to consume a low-salt diet while on this medication."
A low-salt diet is not typically recommended with lithium therapy. In fact, lithium can cause sodium depletion, so it's important for clients to maintain adequate salt intake unless otherwise instructed by their healthcare provider.
D. "You will need your blood levels drawn weekly during the first month."
This statement is correct. Monitoring serum lithium levels is crucial to ensure the medication's effectiveness and prevent toxicity. Initially, frequent monitoring is necessary to establish the appropriate dosage and assess for any signs of toxicity. Weekly blood level checks during the first month of therapy are common practice.
Correct Answer is C
Explanation
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.
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