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?

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.

A. Give the medication: Administering expired medication poses potential risks to the client's safety and efficacy of treatment. Therefore, giving the medication is not appropriate.

B. Discard the medication: Expired medications may have decreased potency or even become harmful due to chemical changes over time. It is essential to discard expired medications to ensure client safety and maintain the effectiveness of treatment.

C. Notify the provider: While it's important to communicate issues related to medication administration to the healthcare provider, in this case, the expired medication should not be used regardless of provider notification.

D. Return the medication to the pharmacy: Returning expired medication to the pharmacy might be appropriate in some settings, but it is not the primary action to take in this situation. The priority is to ensure the client does not receive expired medication.