A physician orders Lithium 1.2 grams/day in three divided doses PO for a client with bipolar disorder. The medication is supplied as 300 mg/5 mL. How much will the nurse administer per dose?

(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

a. Tell me more about what unpleasant effects you have been experiencing

Explanation of Choices

Choice A Reason: Tell Me More About What Unpleasant Effects You Have Been Experiencing

This response is the most appropriate because it opens a dialogue between the nurse, the client, and the parent. Understanding the specific side effects the client is experiencing allows the nurse to gather detailed information, which is crucial for assessing the situation accurately. This approach shows empathy and concern for the client’s well-being and can help identify whether the side effects are manageable or if an alternative treatment plan is needed. It also ensures that the client feels heard and supported.

Choice B Reason: Stop Taking the Medication Immediately

Advising the client to stop taking the medication immediately is not appropriate without a thorough assessment and consultation with the prescribing physician. Abruptly discontinuing ADHD medication can lead to withdrawal symptoms and a resurgence of ADHD symptoms, which can negatively impact the client’s daily functioning and overall health. Medication changes should always be made under medical supervision to ensure safety and effectiveness.

Choice C Reason: I’ll Get the Physician to Discuss This Situation

While involving the physician is an important step, this response alone does not address the immediate concerns of the client and parent. It is essential for the nurse to first understand the specific issues before referring to the physician. This ensures that the physician has all the necessary information to make an informed decision about the client’s treatment plan. Additionally, this response may come across as dismissive if not coupled with an initial assessment by the nurse.

Choice D Reason: It’s Important to Take the Medication as Prescribed

While it is true that taking medication as prescribed is important, this response does not acknowledge the client’s and parent’s concerns about side effects. It may come across as dismissive and could damage the trust between the client, parent, and healthcare provider. Addressing the side effects and exploring possible solutions or alternatives is crucial for maintaining adherence to the treatment plan and ensuring the client’s well-being.

The correct answer is c. Replace fluids.

Choice A Reason: Apply restraints

Applying restraints is generally not the first-line intervention for managing alcohol withdrawal. Restraints should only be used if the patient poses an immediate threat to themselves or others and all other less restrictive measures have failed. The primary focus in the initial phase of alcohol withdrawal is to manage physiological stability and prevent complications.

Choice B Reason: Identify social supports

While identifying social supports is important for long-term recovery and overall mental health, it is not the highest priority during the initial phase of alcohol withdrawal. The immediate concern is to address the acute physiological symptoms and prevent severe complications such as seizures or delirium tremens.

Choice C Reason: Replace fluids

Replacing fluids is the highest priority in the initial phase of alcohol withdrawal. Dehydration is a common issue in patients undergoing withdrawal, and maintaining fluid balance is crucial for preventing complications. Ensuring adequate hydration helps stabilize the patient and supports overall physiological function during the withdrawal process.

Choice D Reason: Orient to reality

Orienting the patient to reality is important, especially if they are experiencing confusion or delirium. However, it is not the highest priority in the initial phase of alcohol withdrawal. The primary focus should be on stabilizing the patient’s physiological condition, including fluid replacement and monitoring vital signs.