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. A key outcome criterion for clients with anxiety disorder is the ability to demonstrate effective coping strategies, such as relaxation techniques or problem-solving, to manage anxiety.
B. Reduced hallucinations would be a goal for a client with a psychotic disorder, not an anxiety disorder.
C. Persistent avoidance behaviors would indicate that the client’s anxiety is not being effectively managed.
D. Feelings of tension and fatigue are common symptoms of anxiety and would not be considered an appropriate outcome for treatment.
Correct Answer is A
Explanation
A. A lithium level of 1.0 mEq/L is within the therapeutic range (0.6 to 1.2 mEq/L). The nurse should administer the morning dose of lithium as prescribed.
B. While it is important to monitor for medication adherence, there is no indication from the current lithium level that this client is refusing the medication.
C. Gastric lavage is unnecessary, as the lithium level is not elevated enough to warrant this extreme intervention.
D. Early signs of lithium toxicity typically occur with levels above 1.5 mEq/L. Since the level is 1.0 mEq/L, the nurse should proceed with administering the medication.
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