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A nurse is caring for a client who is taking lithium. The nurse should monitor for which of the following findings as an adverse effect of the medication?

Positive Chvostek's sign

Increased potassium level

Constipation

Increased urinary output

Answer and Explanation

The Correct Answer is D

A. Chvostek’s sign is associated with hypocalcemia, not lithium toxicity.

B. Lithium does not increase potassium levels; it may cause mild hyponatremia.

C. Lithium is more commonly associated with diarrhea, not constipation.

D. Lithium can cause nephrogenic diabetes insipidus, leading to increased urinary output.

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Correct Answer is B

Explanation

A. Help the client to identify effective past coping skills – While important, this is not the priority in a crisis situation.

B. Initiate precautions to safeguard the client from physical harm – Ensuring immediate safety is the top priority for a client in crisis. If the client is at risk of further harm, protective measures must be implemented.

C. Assist the client to identify available support systems – This is an important step but comes after ensuring safety.

D. Encourage the client to express feelings about the incident – Emotional support is important, but physical safety takes precedence in crisis situations.

A. Shake both insulin vials for 2 min before withdrawing the doses. B. Administer the mixture within 5 min of preparing it. C. Withdraw the NPH insulin before the regular insulin. D. Inject air into the regular insulin vial before injecting air into the NPH vial.

Correct Answer is B

Explanation

A. Insulin vials should not be shaken because this can create air bubbles, leading to inaccurate dosing. Instead, NPH insulin should be gently rolled between the palms to evenly mix the suspension. Regular insulin does not require mixing.

B. Once regular and NPH insulin are mixed, they should be administered promptly to maintain their stability and effectiveness. Delaying administration may alter insulin absorption, leading to unpredictable glucose control.

C. Regular insulin should be drawn up before NPH insulin to prevent contaminating the clear regular insulin with the cloudy NPH insulin. The correct order is to inject air into the NPH vial first (without withdrawing insulin), then inject air into the regular insulin vial, withdraw the regular insulin, and finally withdraw the NPH insulin.

D. The correct technique is to first inject air into the NPH vial, then inject air into the regular insulin vial. This prevents contamination and maintains sterility. However, when withdrawing insulin, regular insulin is drawn first to prevent mixing of NPH insulin into the regular insulin vial.

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A nurse is caring for a client who is taking lithium. The nurse should monitor for which of the following findings as an adverse effect of the medication?

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