A nurse is collecting data from a client who has bulimia nervosa. Which of the following findings should the nurse expect?

A. Lithium can affect sodium and potassium balance in the body, but it does not specifically require a decrease in dietary potassium. Instead, sodium intake should be kept consistent because lithium excretion is influenced by sodium levels. Therefore, decreasing dietary potassium is not a recommended intervention.
B. Lithium can sometimes cause weight gain as a side effect. Increasing daily caloric intake is not a standard intervention when starting lithium. Clients should be encouraged to maintain a balanced diet and regular exercise regimen to manage potential weight changes.

C. Hypoglycemia is not a common side effect of lithium. Therefore, monitoring for hypoglycemia is not necessary when a client is taking lithium.
D. Administering lithium with meals can help reduce gastrointestinal side effects, such as nausea and upset stomach, which are common when starting the medication. It also helps with consistent absorption and reduces the peak serum concentration of lithium, which can minimize side effects and stabilize blood levels.

A. This option is not appropriate for a client with acute delirium. Delirium is characterized by fluctuating levels of consciousness, attention, and cognition. High-stimulation environments, such as loud noises or bright lights, can exacerbate confusion and agitation in these clients. Therefore, providing a calm and quiet environment is crucial to help reduce symptoms of delirium.
B. Delirium can often be worsened during nighttime due to factors like disruption of sleep-wake cycles and disorientation in a new environment. Keeping the client's room dark at night helps to promote rest and reduce disturbances. However, this is not the most important intervention.

C. Family support and presence are typically beneficial for clients, even those with delirium. Family members can provide familiarity, comfort, and assistance in reorienting the client. Discouraging visitation would not be appropriate unless the family members are contributing to increased agitation or confusion. Instead, it's important to educate family members on how to interact with and support the client effectively.
D. Clients with delirium often experience impaired cognition, making decision-making challenging for them. Limiting the client's need to make decisions can help reduce their stress and frustration. It's important for the nurse to simplify choices when possible and provide guidance and support as needed. This approach can help alleviate cognitive load and improve the client's ability to cope.