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
Fluoxetine and other SSRIs can actually have an impact on sexual desire and function as a side effect, often leading to decreased libido. This statement shows a misunderstanding of the medication's potential effects.
B. "I should notify my provider if I develop a skin rash."
Explanation: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression. It's important for clients to be aware of potential side effects and know when to notify their healthcare provider. One potential serious side effect is an allergic reaction or skin rash, which could indicate an adverse response to the medication. Therefore, the client's statement about notifying the provider if a skin rash develops demonstrates their understanding of monitoring for potential adverse reactions.
C. "I should expect relief from depression within 3 to 4 days."
Antidepressant medications like fluoxetine typically take several weeks to start showing significant improvements in symptoms. This statement reflects a misconception about the timeline for therapeutic effects.
D. "I will take my fluoxetine at bedtime so I can sleep better."
Fluoxetine can have stimulating effects for some individuals, so it's often recommended to take it earlier in the day to avoid interference with sleep. Taking it at bedtime could potentially disrupt sleep rather than improve it.
Correct Answer is C
Explanation
A. The client is unwilling to accept that treatment is needed.
This alone may not be sufficient to keep the client under a 72-hour hold. While a person's refusal to accept treatment may indicate a need for care, it might not meet the criteria for involuntary commitment unless there is an immediate danger to the individual or others.
B. The client states that she does not like the neighbor.
Disliking a neighbor is not typically a sufficient reason to place someone under a 72-hour psychiatric hold. The criteria for involuntary commitment usually revolve around a person's potential to harm themselves or others due to their mental state.
C. The client is a danger to herself or others.
Explanation:
In many jurisdictions, a 72-hour psychiatric hold, also known as an involuntary psychiatric hold or emergency detention, allows mental health professionals to detain a person who is considered a danger to themselves or others due to their mental condition. This is done to ensure the safety of the individual and those around them. The hold provides a brief period during which a psychiatric assessment can be conducted to determine the appropriate course of action for the person's mental health treatment.
D. The client states that she plans to move out of the state immediately.
While this statement might raise concerns about the client's stability, it generally would not meet the criteria for a 72-hour hold unless there is clear evidence that the client's immediate move would pose a risk to their own safety or the safety of others. The hold is more focused on imminent danger rather than potential future actions.
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