A nurse is measuring the fundal height of a client who is at 36 weeks of gestation. The client suddenly reports nausea. Which of the following actions should the nurse take?

A. “It will take at least a week before this medication reaches a therapeutic level.” Lithium reaches therapeutic plasma levels in approximately 5–7 days. Clients should be informed that mood stabilization and symptom improvement may not be immediate and may take up to 2–3 weeks.
B. “You will be placed on a low-sodium diet while taking this medication.” This is contraindicated because low sodium intake can increase lithium reabsorption by the kidneys, significantly raising the risk of lithium toxicity. A stable and adequate sodium intake is essential.
C. “This medication can cause weight gain” Weight gain is a common side effect of lithium, often related to changes in metabolism, appetite increase, and fluid retention. Clients should be monitored and provided with dietary and activity guidance.
D. “Blurred vision is an expected adverse effect of this medication.” Blurred vision is not an expected effect of lithium and may indicate toxicity or another medical condition. Any visual changes should prompt immediate evaluation rather than be considered routine.
E. “This medication can cause nausea and drowsiness.” These are common early side effects of lithium, especially during initiation. Taking the medication with food and adjusting administration times may help reduce gastrointestinal upset and sedation.

A. Place locks at the tops of exterior doors: Clients with Alzheimer’s disease are at high risk for wandering. Installing locks out of the client’s line of sight, such as at the tops of doors, enhances safety by reducing the chance of unsupervised exit.
B. Wear clothing with zippers instead of buttons: While simplifying clothing is helpful, Velcro or elastic waistbands are typically easier for clients with cognitive decline than zippers, which can still be difficult to manage.
C. Encourage physical activity prior to bedtime: Physical activity should be scheduled earlier in the day. Stimulating activity near bedtime may worsen sleep disturbances or contribute to sundowning in clients with Alzheimer’s disease.
D. Replace the carpet with hardwood floors: Removing carpet can increase the risk of slipping and falling. Soft flooring like carpet may actually provide better traction and cushion in the event of a fall.