A nurse is reviewing the medication administration records of a group of clients who have been newly admitted to a long-term care facility.
Which of the following clients should the nurse monitor for extrapyramidal symptoms?.

Choice A rationale:

Withholding the dose if having a fine hand tremor is not recommended. Hand tremors are a common side effect of lithium, but they can be managed by adjusting the dose.

Choice B rationale:

Avoiding foods with a high tyramine content is not necessary for lithium users. This dietary restriction is typically associated with certain antidepressants, not lithium.

Choice C rationale:

Limiting daily fluid intake is incorrect. Lithium can cause increased thirst and urination, so it’s important to maintain adequate hydration.

Choice D rationale:

Following a low-sodium diet is not advised. Both salt and fluid can affect the levels of lithium in your blood, so it’s important to consume a steady amount every day.

So, the correct answer is, none of the above.

Choice A rationale:

Pseudoparkinsonism mimics the symptoms of Parkinson’s disease but is not typically characterized by choreiform movements, lip smacking, and spastic facial distortions.

Choice B rationale:

Tardive dyskinesia, a potential side effect of long-term use of chlorpromazine, is characterized by involuntary movements such as lip smacking and facial distortions.

Choice C rationale:

Akathisia is characterized by a sense of restlessness and a compulsion to move, not typically by the symptoms described.

Choice D rationale:

Dystonia involves involuntary muscle contractions and distortions but not typically the specific symptoms described.

So, the correct answer is B.