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 C
Explanation
Rationale:
A. ECT is actually indicated for clients with severe depression or suicidal ideation when rapid symptom relief is necessary.
B. ECT is primarily used for acute treatment, not for relapse prevention. Maintenance medications are typically used to prevent relapse.
C. ECT can be an effective treatment for clients with severe manic episodes, especially when other treatments have failed or the client is a danger to themselves or others.
D. ECT is not first-line; mood stabilizers and antipsychotics are typically used first. ECT is reserved for treatment-resistant or severe cases.
Correct Answer is B
Explanation
Rationale:
A. While depression may contribute to substance use, this choice makes an assumption about the patient's emotional state without adequate context.
B. Individuals with bipolar disorder often use substances like alcohol to manage or "self-medicate" their mood symptoms instead of taking prescribed medications.
C. This statement is overly simplistic and not clinically accurate; behavior is influenced by multiple factors, not just neurotransmitter levels.
D. While anxiety might coexist, this statement is vague and doesn't directly explain the pattern of substituting alcohol for prescribed medications.
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