A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?
Potassium 4.2 mEq/L
Sodium 136 mEq/L
Calcium 9.0 mg/dL
Creatinine 2.1 mg/dL
The Correct Answer is D
A. Potassium 4.2 mEq/L is within the normal range (3.5–5.0 mEq/L).
B. Sodium 136 mEq/L is slightly low but does not warrant withholding lithium. However, sodium levels should be monitored regularly as low sodium increases the risk of lithium toxicity.
C. A calcium level of 9.0 mg/dL is within the normal range (8.5–10.2 mg/dL).
D. An elevated creatinine level (2.1 mg/dL) indicates possible renal dysfunction, which is a concern for lithium use. Lithium is excreted by the kidneys, and impaired renal function increases the risk of lithium toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Blurred vision and ataxia are signs of lithium toxicity. The nurse should withhold the medication and notify the healthcare provider immediately for further evaluation.
B. Administering the next dose of lithium could worsen the toxicity, as these are early signs of lithium overdose.
C. Propranolol is used for controlling tremors or anxiety but does not address lithium toxicity.
D. Levothyroxine is used for thyroid dysfunction, which is not indicated by these symptoms.
Correct Answer is B
Explanation
A. The behavior of picking up after others does not limit interaction time with others; it is driven by anxiety.
B. The compulsive behavior in OCD is often used as a coping mechanism to reduce anxiety. The client is attempting to neutralize or manage obsessive thoughts by performing these repetitive actions.
C. The behavior is not intended to focus attention on meaningful tasks but to alleviate distress.
D. While the behavior might seem to control the environment, the primary motivation is anxiety reduction, not manipulation of others.
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