A nurse is preparing to teach a client about the lithium prescription for treating bipolar disorder. Which of the following statements should the nurse include in the teaching?

Choice A reason:
When a client expresses thoughts of wanting to end their life, it is crucial for the nurse to immediately assess the risk of suicide. Asking the client if they have a plan to commit suicide is a direct approach to gauge the immediacy and seriousness of the risk. This information is vital for determining the next steps in care, which may include close supervision, safety precautions, and urgent psychiatric evaluation.

Choice B reason:
While ensuring the client is comfortable is important, allowing the client to rest without further assessment or intervention may not be safe if the client is at immediate risk of self-harm. The priority is to assess and secure the client's safety.

Choice C reason:
It is inappropriate and potentially dangerous to dismiss the client's statement as manipulation. All expressions of suicidal ideation should be taken seriously, and the nurse should provide a supportive response that addresses the client's emotional state and safety concerns.

Choice D reason:
Notifying the client's family can be part of a broader safety plan, but it should not replace immediate assessment and intervention by the healthcare team. Family members may provide support, but they are not a substitute for professional care and suicide risk assessment.

Choice A reason:
Decreasing the dose of Xanax (alprazolam) is often necessary when a client shows signs of dependency or when there are concerns about potential side effects, such as uncontrolled hypertension. Xanax is a fast-acting benzodiazepine, which can be highly addictive, especially when taken in doses of 4 mg/day for longer than 12 weeks. It is essential to monitor the client's blood pressure and adjust the medication accordingly to avoid exacerbating hypertension.

Choice B reason:
Increasing the dose may temporarily control symptoms of anxiety, but it also increases the risk of dependency and other side effects. Given the client's uncontrolled hypertension, increasing the dose could lead to further complications.

Choice C reason:
This statement is incorrect. Xanax does cause dependency, and it is one of the most addictive benzodiazepine medications on the market today. Dependency can develop quickly, even in users who follow a prescribed dosing schedule.

Choice D reason:
While Ativan (Lorazepam) is also used to treat anxiety, adding it to the client's medication regimen without careful consideration could increase the risk of dependency and adverse effects. Both Xanax and Ativan are benzodiazepines, and their combined use should be monitored closely by a healthcare professional.