A nurse is reviewing the morning laboratory report for a client who has bipolar disorder and recently started taking lithium. The client's current lithium level is 1.2 mEq/L. Which of the following actions should the nurse plan to take?
Administer the regular dose of lithium.
Contact the laboratory to repeat the lithium level.
Obtain an ECG and institute seizure precautions.
Contact the provider to prescribe an increased dose of lithium.
The Correct Answer is A
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.
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Related Questions
Correct Answer is C
Explanation
A. Phenytoin can rarely cause a side effect known as "purple glove syndrome" if it infiltrates into the surrounding tissues during intravenous administration, leading to discoloration. However, this is not relevant to oral suspension administration.
B. Taking an antacid with phenytoin is generally not recommended as it may decrease the absorption of phenytoin. Phenytoin should be taken on an empty stomach to ensure optimal absorption.
C. Phenytoin oral suspension may settle over time, so it's important to shake the bottle well before measuring and administering each dose to ensure uniform distribution of the medication.
D. While obtaining an annual flu vaccine is generally advisable for individuals with epilepsy, it's not directly related to phenytoin administration and should be part of routine healthcare maintenance rather than specific guidance for phenytoin therapy.
Correct Answer is A
Explanation
A. Respiratory depression is a potential side effect of magnesium sulfate toxicity.
Administering calcium gluconate can antagonize the effects of magnesium on smooth muscle and cardiac tissue, helping to counteract respiratory depression and other symptoms of magnesium toxicity.
B. Flumazenil is a benzodiazepine receptor antagonist used to reverse the effects of benzodiazepine overdose, not magnesium sulfate toxicity.
C. Protamine sulfate is used to reverse the anticoagulant effects of heparin, not magnesium sulfate toxicity.
D. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, not magnesium sulfate toxicity.
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