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 D

Explanation

A. Isolating the client is not appropriate, as it can increase anxiety and exacerbate the compulsive behaviors.

B. Setting strict limits can lead to increased anxiety and resistance, making it harder to manage the compulsive behaviors.

C. Confronting the client about the senselessness of their compulsions can increase anxiety and worsen the behavior. It is more helpful to provide a supportive environment that allows for the rituals, gradually decreasing their frequency and intensity.

D. Clients with OCD often perform compulsive rituals to reduce anxiety. Planning time for rituals helps to manage the behavior while maintaining the therapeutic structure and routine on the unit.

A. Potassium B. Sodium C. Vitamin C D. Vitamin K

Correct Answer is B

Explanation

A. Potassium intake is not specifically important for the management of lithium therapy, though potassium levels should be monitored in some situations for general health.

B. Lithium is a mood stabilizer used to treat bipolar disorder, and it is important to maintain a consistent sodium intake. Lithium levels can be affected by changes in sodium levels, as low sodium levels can increase lithium toxicity.

C. Vitamin C is not directly related to lithium therapy and is not necessary for managing its effects.

D. Vitamin K does not have a significant role in lithium therapy and does not impact its effectiveness or toxicity.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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