A nurse is reinforcing teaching with a client who has bipolar disorder and has a new prescription for lithium. To address possible adverse effects, the nurse should include that which of the following laboratory values will be monitored while the client is taking this medication?
Liver enzymes
Uric acid
Erythrocyte sedimentation rate
Sodium level
The Correct Answer is D
A. Monitoring liver enzymes (AST, ALT) is typically not directly related to lithium therapy. Elevated liver enzymes may indicate liver damage from various causes, such as hepatitis or medication toxicity, but it is not a routine monitoring parameter for lithium.
B. Lithium can decrease the excretion of uric acid, potentially leading to elevated levels. Monitoring uric acid levels helps to detect hyperuricemia, which may contribute to conditions like gout. It's important to monitor this parameter periodically during lithium therapy.
C. ESR is a nonspecific marker of inflammation and is not specifically monitored in relation to lithium therapy. It is used to diagnose or monitor conditions like infections, autoimmune diseases, or certain cancers, but it does not directly relate to lithium use.
D. Monitoring serum sodium levels is crucial during lithium therapy because lithium can affect renal function and electrolyte balance, including sodium levels. Hyponatremia is a potential adverse effect of lithium, and regular monitoring helps detect and manage this condition promptly.
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Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
A. Being married is generally considered a protective factor against suicide. Married individuals often have social support and a sense of belonging, which can reduce suicide risk. Therefore, this would not be identified as a risk factor for suicide.
B. Alcohol use disorder is a significant risk factor for suicide. Alcohol can impair judgment, increase impulsivity, and exacerbate underlying mental health issues. It is associated with higher rates of suicidal ideation and attempts.
C. Family history of suicide, including among siblings, is a known risk factor. Exposure to suicide within the family can contribute to feelings of hopelessness, increase perceived acceptability of suicide, and impact mental health negatively.
D. Access to firearms is a well-established risk factor for completed suicide. Firearms are highly lethal, and their presence increases the likelihood of a fatal suicide attempt compared to other means.
E. Terminal illness, including conditions like terminal liver cancer, can contribute to feelings of hopelessness and despair, potentially increasing suicide risk. The distress related to the prognosis and physical symptoms can exacerbate mental health issues.
Correct Answer is A
Explanation
A. Cardiac arrhythmias can be a concern during ECT due to the potential cardiovascular effects of the electrical stimulation. It's crucial to ensure that the client's cardiac status is stable before proceeding with ECT. Certain arrhythmias may require management or stabilization before the procedure can be safely performed.
B. Crohn's disease, an inflammatory bowel disease, may not directly impact the safety of ECT. However, it's important to review if the client is currently experiencing an active flare-up or complications such as dehydration or electrolyte imbalances, which could affect their overall health and readiness for the procedure.
C. Asthma itself is typically not a contraindication for ECT. However, if the client has poorly controlled asthma or is experiencing an exacerbation, it could pose a risk during the procedure, especially if sedation or anesthesia is used. The nurse should ensure asthma is well-managed before proceeding with ECT.
D. Renal colic refers to pain caused by kidney stones. This condition is not typically a direct contraindication for ECT. However, pain and discomfort from renal colic could affect the client's tolerance of the procedure, especially if sedation or anesthesia is required.
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