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?
Thyroid enlargement
Constipation
Hyporeflexia
Elevated blood pressure
The Correct Answer is A
A. Lithium can cause hypothyroidism and goiter as adverse effects. Therefore, monitoring of thyroid function and physical examination for thyroid enlargement is necessary during lithium therapy.
B. Constipation is not a typical adverse effect of lithium carbonate. It's more commonly associated with side effects such as nausea, diarrhea, or polyuria.
C. Hyporeflexia is not commonly associated with lithium carbonate use. Lithium more commonly affects the central nervous system, leading to symptoms such as tremors, confusion, and seizures in cases of toxicity.
D. Lithium is more commonly associated with the opposite effect, lowering blood pressure rather than elevating it. It's known to have effects on sodium transport in renal tubules, leading to increased water retention and possibly hypotension.
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Related Questions
Correct Answer is A
Explanation
A. A lithium level of 1.2 mEq/L falls within the therapeutic range (0.6-1.2 mEq/L) for the treatment of bipolar disorder. Therefore, the nurse should administer the regular dose of lithium as prescribed and closely monitor the client for any side effects.
B. Repeating the lithium level is unnecessary because the current level is within the therapeutic range. Repeated testing may be warranted if the level is outside the therapeutic range or if there are clinical concerns.
C. This action is not indicated for a lithium level within the therapeutic range. ECG and seizure precautions are typically reserved for lithium toxicity, which presents with levels above the therapeutic range.
D. Increasing the dose of lithium is not warranted when the current level is within the therapeutic range. Doing so could increase the risk of toxicity.
Correct Answer is D
Explanation
A. Akathisia refers to a subjective feeling of restlessness and an objective inability to sit still.
It's characterized by a need to move constantly and is not typically associated with choreiform movements, lip smacking, or spastic facial distortions.
B. Dystonia involves sustained or intermittent muscle contractions leading to abnormal postures or twisting movements. It typically presents with muscle spasms, not choreiform movements or lip smacking.
C. Pseudoparkinsonism refers to a collection of symptoms that resemble Parkinson's disease, such as tremor, bradykinesia, rigidity, and postural instability. It does not typically involve choreiform movements or lip smacking.
D. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face and body, including choreiform movements (rapid, jerky movements), lip smacking, and spastic facial distortions. It often develops after long-term use of antipsychotic medications like chlorpromazine and can persist even after discontinuation of the medication.
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