An outpatient diagnosed with bipolar disorder is prescribed lithium. The patient telephones the nurse to say, "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" The nurse will advise the patient to
have someone bring the patient to the clinic immediately.
restrict food and fluids for 24 hours and stay in bed.
take one dose of an over-the-counter antidiarrheal medication now.
drink a large glass of water with 1 teaspoon of salt added.
The Correct Answer is A
Rationale:
A. Severe diarrhea, worsening tremor, weakness, and unsteady gait are signs of possible lithium toxicity, which requires immediate medical evaluation; the patient should be brought to the clinic promptly.
B. Restricting fluids can worsen dehydration and increase lithium concentration, making toxicity more likely.
C. Taking an antidiarrheal does not address the underlying problem and may delay urgent treatment.
D. Adding salt and water will not reverse toxicity and could delay necessary medical intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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.
Correct Answer is C
Explanation
Rationale:
A. This indicates continued manic behavior such as distractibility and impulsivity, suggesting the treatment has not yet been effective.
B. These symptoms are consistent with acute mania, including poor sleep and distractibility, showing that the condition persists.
C. This reflects improvement in mood, behavior, and thought organization, indicating that the treatment is effective.
D. These are signs of ongoing manic behavior, especially impulsivity and rapid, excessive speech.
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