Assessment of a client reveals severe and sudden mood swings from mania to depression. Which diagnosis should the nurse suspect?

D. Peer relationships are critically important during adolescence. Positive peer relationships can provide emotional support, a sense of belonging, and opportunities for socialization and development of social skills. On the other hand, negative peer relationships, such as bullying, social exclusion, or conflicts with peers, can contribute to feelings of loneliness, rejection, and depression.

A. While positive communication between teachers and teenagers can contribute to academic success and emotional support, it is not typically listed as a primary factor directly related to depression in adolescence. Issues related to academics and school performance may indirectly affect depression, but direct communication with teachers is less likely to be a significant factor compared to other options.

B. Effective communication between parents and teenagers plays a crucial role in adolescent development. Supportive and open communication can help adolescents feel understood, validated, and supported, which can have a protective effect against depression. Conversely, poor communication or conflict within the family environment can contribute to feelings of isolation, distress, and ultimately depression.

C. Academic stress, performance pressure, and difficulties in school can significantly impact an adolescent's mental health. High expectations, bullying, academic failure, or feeling overwhelmed by schoolwork can contribute to feelings of inadequacy, low self-esteem, and depression in adolescents.

A. Lithium is excreted primarily by the kidneys, and its clearance can be affected by changes in fluid balance. It's important for clients taking lithium to maintain a stable and adequate fluid intake to help regulate lithium levels in the body. Stable fluid intake helps maintain electrolyte balance, which is crucial for the proper function of lithium and prevention of adverse effects.

B. Lithium can affect sodium reabsorption in the kidneys. High levels of sodium intake can alter lithium levels in the body, potentially leading to toxicity. Therefore, clients on lithium therapy are often advised to maintain a consistent and moderate level of sodium intake. Excessive dietary salt can interfere with lithium's therapeutic effects.

C. Restricting fluid intake is not recommended unless there are specific medical reasons to do so. Lithium therapy generally requires adequate hydration to maintain kidney function and prevent dehydration, which can affect lithium levels.

D. Exercising in hot weather can lead to increased sweating and fluid loss, which can potentially affect lithium levels by altering hydration status. However, the primary concern during exercise in hot weather is maintaining adequate hydration rather than restricting it.