A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

A. Dispose of the remaining medication while another nurse observes:
This is the correct choice. When a nurse administers a fraction of a tablet, it is not safe or appropriate to store the remaining portion for future use, even if another dose is scheduled. Hydromorphone tablets are meant to be taken whole, and cutting or breaking them can lead to inconsistent dosages. It's important to follow safe medication administration practices and dispose of the unused portion while another nurse observes, ensuring proper disposal.
B. Store the remaining half of the pill in the automated medication dispensing system:
This choice is incorrect. Storing a fraction of a tablet in the automated medication dispensing system is not appropriate. The system is designed for intact medications, and splitting tablets could compromise the accuracy and safety of future doses.
C. Place the remaining half of the pill in the unit-dose package:
This choice is incorrect. Placing a partial tablet back into a unit-dose package could lead to confusion and potential administration errors in the future. The medication packaging should reflect the correct and complete dosage as prescribed.
D. Return the remaining medication to the facility's pharmacy:
This choice is incorrect. Returning a partially used tablet to the pharmacy is not advisable, as the pharmacy cannot ensure the tablet's integrity or accurately verify its dosage. Medication storage and handling standards are in place to ensure patient safety, and using a fraction of a tablet may compromise those standards.

A. "I will need to have blood levels drawn."
Theophylline is a medication used to treat respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). It is important to monitor the blood levels of theophylline because it has a narrow therapeutic range – meaning that there is a fine line between a therapeutic dose and a toxic dose. Regular blood tests help to ensure that the client is receiving the appropriate dose for their condition.
B. "I can take my medication in the morning with my coffee." - Theophylline should be taken consistently with meals, so taking it with coffee might not be ideal as it can affect its absorption.
C. "I may sprinkle the medication in applesauce." - Theophylline is usually taken as a sustained-release capsule, which means it is designed to release the medication slowly over time. Crushing or sprinkling the medication can disrupt this mechanism and lead to unintended consequences.
D. "I should limit my fluid intake while on this medication." - There's no requirement to limit fluid intake with theophylline, and in fact, adequate hydration can help prevent some side effects of the medication.