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. Arthritis does not typically affect lithium metabolism or clearance.
B. Heart failure can impair renal function and fluid balance, increasing the risk of lithium toxicity and making serum concentration monitoring critical.
C. Psoriasis does not interfere with lithium pharmacokinetics.
D. Epilepsy is not directly related to lithium metabolism, though caution is warranted if the patient is on other medications.
Correct Answer is A
Explanation
Rationale:
A. Poor judgment and hyperactivity are characteristic of mania, demonstrated by risky behavior (posting on official sites, inviting politicians) and prolonged activity without rest.
B. Increased muscle tension and anxiety are more typical of anxiety disorders, not classic manic episodes.
C. Vegetative signs (e.g., sleep and appetite disturbances) occur but poor grooming is more common in depression than mania.
D. Cognitive deficits and paranoia may be seen in psychosis but are not the primary features described here.
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