A nurse is reviewing the laboratory report of a client who has bipolar disorder prior to the administration of lithium carbonate. The client's lithium level is.6 mEq/L.
Which of the following actions should the nurse take?
Assist the client to a left lateral position.
Implement fluid restrictions.
Request a dosage increase from the provider.
Prepare the client for hemodialysis.
The Correct Answer is C
- A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
- B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
- C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
- D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should instruct the client to administer the medication through clothing if necessary.

In an emergency, an epinephrine auto-injector can be given through clothing.
Choice A is wrong because massaging the site after injection is not mentioned as something to avoid in the instructions for using an epinephrine auto-injector.
Choice B is wrong because the medication should be injected into the outer thigh, not the abdomen.
Choice D is wrong because aspiration prior to administration of the medication is not mentioned as a necessary step in the instructions for using an epinephrine auto-injector.
Correct Answer is D
Explanation
Ceftriaxone is contraindicated for this client because it is a cephalosporin antibiotic, which has a similar structure to penicillin and can cause cross-reactivity in individuals with a penicillin allergy.
Choice A is wrong because Vancomycin is not a beta-lactam antibiotic and does not have cross-reactivity with penicillin.
Choice B is wrong because Clarithromycin is a macrolide antibiotic and does not have cross-reactivity with penicillin.
Choice C is wrong because Metronidazole is a nitroimidazole antibiotic and does not have cross-reactivity with penicillin.
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