A nurse is reinforcing teaching with a client who takes lithium carbonate for bipolar disorder.
For which of the following findings should the nurse monitor as an adverse effect of lithium carbonate?.

Choice A rationale:

Switching brands of phenytoin can lead to variations in drug absorption and serum drug levels, potentially leading to a loss of seizure control or toxicity. Therefore, this is not a correct instruction.

Choice B rationale:

Altering the phenytoin administration regimen each week can lead to fluctuations in serum drug levels, potentially leading to a loss of seizure control or toxicity. Therefore, this is not a correct instruction.

Choice C rationale:

Phenytoin does not turn urine blue. This is a side effect associated with some other medications, but not phenytoin. Therefore, this is not a correct instruction.

Choice D rationale:

Alcohol can increase serum phenytoin levels, potentially leading to toxicity. Therefore, this is a correct instruction.

So, the correct answer is D. Alcohol increases the chance of phenytoin toxicity.

Choice A rationale:

Blood backing up in the IV tubing indicates a problem with the IV line, not necessarily infiltration.

Choice B rationale:

A long red streak up the arm could indicate phlebitis, not infiltration.

Choice C rationale:

Loose tape could cause the IV needle to dislodge, but it doesn’t directly indicate infiltration.

Choice D rationale:

Swelling around the IV site is a common sign of infiltration.

So, the correct answer is D. “My baby’s fingers are looking swollen.”.