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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Hearing voices could indicate psychosis, which is not specifically linked to acute mania in bipolar disorder. Mania may involve delusions or grandiosity but not auditory hallucinations.

B. Dressing in all black is not specific to acute mania and could be related to personal style or another mood state.

C. Disorganized speech is a hallmark symptom of acute mania in bipolar disorder. The individual may exhibit flight of ideas, rapid speech, or incoherent thoughts.

D. Weight gain is more commonly associated with depression or medication side effects, not acute mania.

A. Avoid driving or operating heavy machinery until you know how alprazolam affects you. B. Relief of manifestations should be expected after a few weeks of therapy. C. Foods that are known to be high in dietary tyramine should be avoided. D. Increase the dose of medication as needed if relief of manifestations is not experienced.

Correct Answer is A

Explanation

A. Alprazolam is a benzodiazepine that can cause drowsiness, dizziness, and impair motor coordination. Therefore, the nurse should advise the client to avoid activities that require alertness until they understand how the medication affects them.

B. Alprazolam provides relatively quick relief of anxiety symptoms, often within hours, rather than requiring weeks of therapy like some other medications.

C. Foods high in tyramine are a concern for clients taking monoamine oxidase inhibitors (MAOIs), not alprazolam.

D. Increasing the dose without guidance from a healthcare provider is unsafe. The client should not adjust their medication dosage without consulting the provider.

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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?

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Naxlex Comprehensive Predictor Exams

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