A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse could teach the client which of the following factors puts her at risk for lithium toxicity?
A client runs 4 miles outdoors every afternoon.
The client eats 2 to 3 gm of sodium-containing foods daily.
The client drinks 2 liters of liquids daily.
The client eats foods high in tyramine.
The Correct Answer is A
A. Lithium is excreted through the kidneys, and dehydration and sodium depletion increase the risk of lithium toxicity. A client who runs 4 miles outdoors every afternoon is at risk of excessive sweating and fluid loss, which can lead to dehydration and sodium depletion. This reduces lithium excretion, leading to toxic levels in the blood.
B. A normal sodium intake helps maintain lithium balance. A low sodium intake increases lithium retention, but 2-3 grams/day is within the normal recommended range.
C. Adequate hydration helps prevent lithium toxicity. Clients on lithium should drink 2–3 liters of fluid daily to promote kidney function and lithium excretion.
D. Tyramine-rich foods (e.g., aged cheese, cured meats) are a concern for clients on monoamine oxidase inhibitors (MAOIs), not lithium. Tyramine does not affect lithium levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Praise the client for looking at herself in a mirror.
While body image concerns are common in anorexia nervosa, praising the client for looking at herself in a mirror may inadvertently reinforce the focus on appearance and body image, which can be counterproductive.
B. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise.
Explanation: For a client with anorexia nervosa, overexercising can be part of the unhealthy behaviors associated with the disorder. Collaborative communication is important in addressing and managing these behaviors. Asking the client to agree to talk to a nurse whenever the urge to exercise arises is a supportive approach. It allows the nurse to provide emotional support, explore the client's motivations and triggers for overexercising, and work together on finding healthier coping strategies.
C. Reprimand the client about the potential damage that has occurred due to overexercising her body.
Reprimanding the client may lead to feelings of guilt and shame, which are counterproductive in supporting recovery. A more empathetic and supportive approach is needed.
D. Restrict the client from being weighed.
Restricting the client from being weighed might exacerbate anxiety around weight gain and contribute to the client's preoccupation with weight. However, monitoring weight under the supervision of healthcare professionals is important in managing anorexia nervosa.
Correct Answer is B
Explanation
A. A client exhibiting psychotic behavior
Group therapy is generally not recommended for clients who are actively exhibiting psychotic behavior. Psychotic behavior can include hallucinations, delusions, and severe thought disturbances, which might impede the individual's ability to effectively participate and benefit from group therapy. Such clients often require more immediate and individualized attention to address their acute symptoms.
B. A client who has been taking amitriptyline for 3 months for depression
This is the correct choice. A client who has been taking amitriptyline for 3 months for depression is likely to have their symptoms more stabilized and under better control compared to acute situations. They might be at a stage where they can engage in group therapy to discuss their experiences, coping strategies, and learn from others in a similar situation.
C. A client who is experiencing alcohol intoxication
Group therapy is not appropriate for clients who are currently intoxicated, as their ability to actively participate and engage in therapeutic discussions may be compromised. Addressing the effects of alcohol intoxication and ensuring the client's safety would be a priority before considering group therapy.
D. A client admitted 12 hours ago for acute mania
Clients admitted for acute mania often require stabilization and intervention to manage their manic symptoms. In the early stages of admission, they might not be in a state conducive to group therapy. Once their acute symptoms are better controlled and they have had time to stabilize, they could potentially benefit from group therapy as part of their overall treatment plan.
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