A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

He will monitor your lithium levels closely while you are taking this medication."

This medication is addictive, so you will need to discontinue it in six months."

"Weight gain should be reported to your provider as an indication of lithium toxicity."

"Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Answer and Explanation

The Correct Answer is A

Lithium is a commonly used medication for treating bipolar disorder, and therapeutic drug monitoring is crucial to ensure its effectiveness and prevent potential toxicity. Monitoring the client's lithium levels in the blood is important because lithium has a narrow therapeutic range, meaning that levels that are too low might not provide the desired therapeutic effect, while levels that are too high can lead to toxicity.

B) "This medication is addictive, so you will need to discontinue it in six months."

Lithium is not considered addictive. It's important to provide accurate information about the nature of the medication to avoid unnecessary concerns.

C) "Weight gain should be reported to your provider as an indication of lithium toxicity."

While weight gain can be a side effect of some medications, it's not a specific indicator of lithium toxicity. Lithium toxicity is characterized by a range of symptoms including tremors, confusion, nausea, vomiting, and excessive thirst, among others.

D) "Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Diuretics are generally not recommended with lithium because they can increase the risk of lithium toxicity. Lithium can affect kidney function, and using diuretics may exacerbate this effect. The client should be advised not to use diuretics without consulting their healthcare provider.

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Correct Answer is A

Explanation

A. "Are you thinking of harming yourself?": Correct

This is the priority response because it directly addresses the client's statement about being better off gone, which raises concerns about potential suicidal thoughts. Asking this question allows the nurse to assess the client's risk of self-harm or suicide and take appropriate actions to ensure their safety.

B. "Do you really think your family would be better off without you?": Incorrect

While this response attempts to engage the client in a conversation, it doesn't directly address the immediate concern of suicidal thoughts. It's important to prioritize assessing the client's safety before exploring their feelings about their family's perspective.

C. "When did you first start feeling this way?": Incorrect

While understanding the client's history and the onset of their feelings is important, it's not the priority response in this situation. Assessing the client's risk of harm takes precedence over gathering historical information.

D. "Tell me what is happening right now.": Incorrect

This response doesn't directly address the client's statement about being better off gone and doesn't assess the immediate risk of self-harm or suicide. While understanding the client's current situation is valuable, safety concerns should be addressed first.

A. "Using nontraditional treatments is not a good idea. I'd rather you avoid that route." B. "Your provider is very knowledgeable. If he prescribes chemotherapy, it's the best treatment for you." C. "A lot of people think nontraditional treatments will work, and they find out too late that they made the wrong choice." D. "Tell me more about your concerns about taking chemotherapy."

Correct Answer is D

Explanation

A. "Using nontraditional treatments is not a good idea. I'd rather you avoid that route."

This response is directive and dismissive of the client's choice. It does not promote open communication or respect for the client's autonomy and beliefs.

B. "Your provider is very knowledgeable. If he prescribes chemotherapy, it's the best treatment for you."

While healthcare providers have expertise, this response doesn't address the client's concerns or give them an opportunity to express their feelings. It may come across as authoritarian and not respecting the client's wishes.

C. "A lot of people think nontraditional treatments will work, and they find out too late that they made the wrong choice."

This response uses scare tactics and doesn't address the client's individual needs or concerns. It does not foster a trusting and respectful nurse-client relationship.

D. "Tell me more about your concerns about taking chemotherapy."

This is the most appropriate response. It demonstrates active listening, empathy, and a willingness to understand the client's perspective. By asking the client to share more about their concerns, the nurse can engage in a meaningful conversation and provide information and support based on the client's needs.

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A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

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