A nurse is collecting data from a client who is taking lithium. Which of the following findings should the nurse identify as early manifestations of lithium toxicity? (Select all that apply.)
Incoordination
Polyuria
Nausea
Convulsions
Confusion
Correct Answer : A,C,E
A. Incoordination, such as clumsiness or difficulty walking, can be an early sign of lithium toxicity. It reflects the neurological effects of elevated lithium levels on motor coordination.
B. Polyuria (excessive urination) is a common late symptom of lithium toxicity. Lithium interferes with the kidney's ability to concentrate urine, leading to increased urine output.
C. Nausea is a gastrointestinal symptom that can occur in the early stages of lithium toxicity. It is often accompanied by other gastrointestinal disturbances such as vomiting and diarrhea.
D. Convulsions (seizures) are not typically considered early manifestations of lithium toxicity but rather indicate severe toxicity. Seizures can occur at higher levels of lithium toxicity and require immediate medical intervention.
E. Confusion is another early sign of lithium toxicity. It reflects the impact of elevated lithium levels on the central nervous system, leading to cognitive impairment and altered mental status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dual diagnosis treatment programs are specifically designed for individuals who have both a mental health disorder (such as ASPD) and a substance use disorder (alcohol dependency in this case). These programs integrate treatment approaches that address both conditions concurrently. They typically involve a combination of medication management, psychotherapy, and support groups tailored to dual diagnosis clients. Encouraging the client to participate in a dual diagnosis treatment group can help address the complex interplay between ASPD and alcohol dependency.
B. Codependency support groups focus on relationships where one person may enable or support dysfunctional behavior in another person. While relevant in certain contexts, codependency support groups may not directly address the primary issues of ASPD and alcohol dependency. Therefore, this option is less appropriate compared to dual diagnosis treatment for this client.
C. Psychodrama is a form of therapy where clients act out real-life situations to explore and gain insights into their feelings, behaviors, and relationships. While psychodrama can be beneficial for emotional expression and role-playing, it may not directly target the core symptoms and challenges of ASPD and alcohol dependency. Therefore, it may not be the most effective intervention for this client compared to dual diagnosis treatment.
D. Crisis intervention focuses on immediate stabilization and support during a mental health crisis or acute episode. While crisis intervention may be necessary at times, it is not a comprehensive treatment approach for ASPD and alcohol dependency. Long-term management and therapeutic interventions, such as dual diagnosis treatment, are typically needed to address these chronic conditions effectively.
Correct Answer is B
Explanation
A. This response could come across as blaming or judgmental. It implies that the client made a mistake by not seeking help, which can exacerbate feelings of guilt or shame. It does not promote an open dialogue or supportive environment.
B. This response demonstrates empathy and a willingness to understand the client's emotional state leading up to the suicide attempt. It encourages open communication about the client's feelings and experiences, which is crucial for assessment and intervention planning.
C. This response suggests that the nurse is making assumptions about the client's emotions without allowing the client to express themselves fully. While guilt may be a common emotion after a suicide attempt, it's important for the nurse to first listen to the client's own description of their feelings.
D. This response minimizes the seriousness of the client's experience and emotions. It may invalidate the client's feelings of distress or despair that led to the suicide attempt. Such a response does not acknowledge the gravity of the situation or provide the necessary support.
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