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?

Hypomagnesemia

Hyponatremia

Hypocalcemia

Hypokalemia

Answer and Explanation

The Correct Answer is A

A. Hypomagnesemia:
Correct Answer: This electrolyte imbalance is the one the nurse should assess the client for.
Explanation: Lithium is primarily excreted by the kidneys, and its excretion can be influenced by factors that affect renal function, including electrolyte imbalances. Hypomagnesemia (low magnesium levels) can potentially reduce the excretion of lithium, leading to increased lithium levels in the blood. This can increase the risk of lithium toxicity, which can be dangerous. Therefore, monitoring magnesium levels is important in clients taking lithium.
B. Hyponatremia:
Incorrect Explanation: While hyponatremia (low sodium levels) is a potential concern, it is not as directly linked to lithium interaction as hypomagnesemia.
Explanation: Lithium can cause diabetes insipidus, which leads to excessive urination and subsequent loss of water and electrolytes, including sodium. However, hyponatremia is not the immediate electrolyte imbalance that arises due to the interaction with lithium.
C. Hypocalcemia:
Incorrect Explanation: Hypocalcemia (low calcium levels) is not a primary concern in the context of lithium use.
Explanation: Lithium does not have a direct interaction with calcium levels. Hypocalcemia is typically not a result of lithium use or its interaction with other factors.
D. Hypokalemia:
Incorrect Explanation: While electrolyte imbalances like hypokalemia (low potassium levels) can have health implications, it is not the primary electrolyte imbalance to be concerned about with lithium use.
Explanation: Hypokalemia is not a direct consequence of lithium interaction. Monitoring potassium levels is important for overall health, but it's not the primary electrolyte imbalance associated with lithium use and its potential interactions.

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Correct Answer is D

Explanation

A. Administer the medication into the client's muscles.
Explanation: This is incorrect because enoxaparin is usually administered subcutaneously, not into the muscle.
B. Apply firm pressure to the injection site following administration.
Explanation: This is incorrect because while applying gentle pressure after a subcutaneous injection is common practice, it is not specific to enoxaparin.
C. Insert the syringe needle halfway into the client's skin.
Explanation: This is incorrect because the needle should be inserted fully into the subcutaneous tissue, not just halfway, for proper administration of enoxaparin.
D. Expel the air bubble from the syringe prior to injection.
Explanation: This is the correct action. Expelling air bubbles from the syringe prior to injection helps ensure accurate dosing and prevents air from being injected into the subcutaneous tissue.
When administering enoxaparin (low molecular weight heparin) subcutaneously, it's important to expel any air bubbles from the syringe before injection. Air bubbles can cause discomfort and inaccuracies in dosage. The nurse should gently tap the syringe to move air bubbles to the top and then push the plunger slightly to expel the air. The other options are not correct procedures for administering enoxaparin. It is typically injected into the subcutaneous tissue, not a muscle, and firm pressure is not typically applied after administration. The needle is fully inserted into the skin, not halfway.

A. "Decrease your daily sodium intake." B. "Take this medication 2 hours before a meal." C. "Limit foods containing tyramine." D. "Report swelling of the feet to your provider."

Correct Answer is D

Explanation

A. "Decrease your daily sodium intake."
Incorrect Explanation: This instruction is appropriate for a client taking lithium carbonate.
Explanation: Lithium is a mood-stabilizing medication commonly prescribed for conditions like bipolar disorder. High levels of sodium can lead to increased lithium retention in the body, potentially raising the risk of toxicity. Advising the client to decrease their daily sodium intake helps prevent this.
B. "Take this medication 2 hours before a meal."
Incorrect Explanation: This instruction is not accurate for lithium carbonate.
Explanation: Lithium carbonate is typically taken with food or milk to help minimize stomach upset. Taking it on an empty stomach might increase the risk of gastrointestinal side effects.
C. "Limit foods containing tyramine."
Incorrect Explanation: This instruction is not directly relevant to lithium carbonate.
Explanation: Tyramine is a compound found in some foods and can interact with certain medications like monoamine oxidase inhibitors (MAOIs), but it is not a primary concern with lithium carbonate.
D. "Report swelling of the feet to your provider."
Correct Explanation: This instruction is appropriate for a client taking lithium carbonate.
Explanation: Lithium can lead to water retention, which might result in swelling, particularly in the feet and ankles. Reporting swelling is important as it can be an early sign of potential side effects or changes in kidney function.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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