A nurse is reinforcing teaching with a client about a new prescription for lithium.
Which of the following statements should the nurse include in the teaching?
Your provider will prescribe a diuretic while you are taking lithium.
Weight gain is a manifestation of lithium toxicity.
We will need to check your lithium levels in the next 3 to 5 days.
Your lithium will be discontinued in 6 months to prevent addiction.
The Correct Answer is C
Rationale for Choice A:
Diuretics are not routinely prescribed with lithium. While diuretics can increase the excretion of lithium, this can also lead to decreased lithium levels and potentially reduced effectiveness. Therefore, diuretics are generally only used in specific situations, such as when a client has lithium-induced edema or congestive heart failure. In such cases, the client's lithium levels would be closely monitored to ensure they remain within the therapeutic range.
Rationale for Choice B:
Weight gain is not a common manifestation of lithium toxicity. In fact, weight gain is a potential side effect of lithium therapy, but it is not typically associated with lithium levels reaching a toxic range. Other signs and symptoms of lithium toxicity include:
Tremor
Nausea and vomiting
Diarrhea
Confusion
Slurred speech
Ataxia
Seizures
Coma
Rationale for Choice C:
Monitoring lithium levels is essential to ensure that the client is receiving a therapeutic dose and to avoid toxicity. Lithium has a narrow therapeutic index, meaning that there is a small difference between the dose that is effective and the dose that is toxic. Regularly checking lithium levels allows the healthcare provider to adjust the dose as needed to maintain a safe and effective level.
The initial lithium level is typically checked within 3 to 5 days of starting the medication, and then periodically thereafter.
The frequency of monitoring may vary depending on the client's individual factors, such as age, kidney function, and other medications they are taking.
Rationale for Choice D:
Lithium is not typically discontinued after a specific period of time. It is often used as a long-term treatment for bipolar disorder to prevent the recurrence of manic and depressive episodes. The decision to discontinue lithium is made on a caseby-case basis, in consultation with the client and their healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Administering an anti-anxiety medication may not be the most appropriate first action. While medication can help to reduce anxiety, it does not address the underlying issue of suicidal ideation. In some cases, medications can even increase the risk of suicide, especially in the first few weeks of treatment.
Instituting mouth checks to assure the medication is swallowed is not a standard practice in this situation. It is more important to focus on ensuring the client's safety and providing emotional support.
Choice B rationale:
Informing the provider about the client's statement is important, but it is not the first action that the nurse should take. The priority is to ensure the client's immediate safety.
The provider can be informed after the client has been stabilized and is no longer at immediate risk of harm.
Choice C rationale:
Assuring that a staff member stays with the client at all times is the most important first step in ensuring the client's safety. This will help to prevent the client from acting on their suicidal thoughts and provide an opportunity for the nurse to assess the client's risk for suicide and intervene as needed.
It also allows the nurse to provide emotional support and reassurance to the client.
Choice D rationale:
Questioning the client about a suicide plan and method is important, but it should not be done until the client's safety has been ensured. Asking about a suicide plan can be triggering for some clients and may increase their risk of suicide.
It is important to approach this topic sensitively and only when the client is feeling safe and supported.
Correct Answer is C
Explanation
A rationale:
Going to another room and reading for 20 minutes when waking up at night is a recommended strategy for managing insomnia. This technique helps to break the cycle of lying in bed awake and worrying, which can worsen insomnia. Reading can be a relaxing activity that can help to promote sleepiness. It's important to choose a book that is not too stimulating and to avoid reading in bright light.
Choice B rationale:
Stopping napping in the afternoon is also a recommended strategy for managing insomnia. Napping can interfere with nighttime sleep by reducing sleep drive. It's best to avoid napping altogether or to limit naps to 30 minutes or less early in the afternoon.
Choice C rationale:
Watching television in the bedroom is not recommended for managing insomnia. The light from the television can suppress the production of melatonin, a hormone that helps to regulate sleep. The noise from the television can also be stimulating and make it difficult to fall asleep. It's best to avoid watching television in the bedroom or to turn off the television at least 30 minutes before bedtime.
Choice D rationale:
Eating the evening meal at least 3 hours before bed is generally a good practice for sleep hygiene. Eating too close to bedtime can lead to indigestion, which can make it difficult to fall asleep. It's best to avoid heavy, fatty, or spicy foods before bed.
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