A patient has been admitted and the nurse suspect lithium toxicity. What symptoms should be suspected with a patient who has to
shortness of breath, gastrointestinal distress, chronic cough
weakness, nausea, diarrhea
ECG changes, chest pain, dizziness
gastrointestinal distress, thirst, nystagmus
The Correct Answer is B
Rationale:
A. Shortness of breath and chronic cough are not typical early signs of lithium toxicity; these suggest possible respiratory or cardiac issues unrelated to lithium.
B. Early signs of lithium toxicity include gastrointestinal upset (nausea, diarrhea) and neuromuscular effects such as weakness.
C. ECG changes and chest pain can occur with severe toxicity, but they are not the most common initial symptoms.
D. Thirst may be a side effect of lithium due to nephrogenic diabetes insipidus, and nystagmus can occur in severe neurotoxicity, but these are not the classic early warning signs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. A lithium serum level between 0.6 and 1.2 mEq/L is generally considered within the therapeutic range for maintenance treatment.
B. Above therapeutic limits would typically be >1.5 mEq/L, which increases toxicity risk.
C. While timing of blood draw is important, an 8-hour interval is acceptable for monitoring lithium levels (usually drawn 12 hours post-dose but 8 hours is still interpretable).
D. A level of 1 mEq/L is not below therapeutic limits.
Correct Answer is B
Explanation
Rationale:
A. This approach is confrontational and accusatory, which may escalate agitation in a hyperactive or manic patient.
B. This response sets clear limits in a calm, supportive, and non-threatening manner, while also offering assistance with impulse control.
C. This statement is shaming and could escalate aggression rather than de-escalate the situation.
D. This is a threat rather than a therapeutic intervention, and it may increase the patient's agitation or resistance.
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