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 D
Explanation
Choice A rationale:
Increased salivation is a common side effect of haloperidol, but it is not the most serious adverse effect that the nurse should monitor for. It can be managed with medications such as anticholinergics, and it often subsides with continued use of haloperidol. Choice B rationale:
Serotonin syndrome is a rare but potentially life-threatening condition that can occur when haloperidol is combined with other medications that increase serotonin levels, such as antidepressants. However, it is not a direct adverse effect of haloperidol itself.
Choice C rationale:
Increased menstrual bleeding is not a known side effect of haloperidol.
Choice D rationale:
Tardive dyskinesia is a serious and potentially irreversible movement disorder that can occur as a long-term side effect of haloperidol and other antipsychotic medications. It is characterized by involuntary, repetitive movements of the face, tongue, and limbs.
The risk of tardive dyskinesia increases with the length of time that a person takes haloperidol and with the dose of the medication.
There is no cure for tardive dyskinesia, but the symptoms can sometimes be managed with medications.
It is important for nurses to monitor patients who are taking haloperidol for signs of tardive dyskinesia, so that the medication can be discontinued if necessary.
Correct Answer is ["A","D"]
Explanation
The correct answer is choice A and D.
Choice A rationale:
Establishing rapport with the client is a fundamental nursing action to create a trusting relationship, which is especially important when a client is experiencing acute anxiety. A strong rapport can help the client feel more secure and supported, making it easier to manage their anxiety.
Choice B rationale:
Making eye contact is generally considered a non-threatening and effective way to communicate care and attention. Avoiding eye contact could make the client feel isolated or ignored. Therefore, this is not a recommended action when attending to a client with acute anxiety.
Choice C rationale:
Using a high-pitched voice can be perceived as alarming or stressful, which may exacerbate the client’s anxiety. It is important to use a calm, soothing tone when speaking to someone who is anxious.
Choice D rationale:
Validating the client’s feelings and identifying the cause of the anxiety are therapeutic techniques that acknowledge the client’s experience and can help in addressing the underlying issues contributing to the anxiety. This can be a crucial step in helping the client to cope with and overcome their anxiety.
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