The nurse is asking a diagnosed schizophrenic patient how they slept and they respond, "This is a new day in May and I can't wait to play." Which communication pattern does the nurse identify?

Choice A rationale:

Ingesting lithium (Eskalith) on an empty stomach can lead to gastrointestinal upset. Therefore, clients are generally advised to take this medication with food or milk to minimize these side effects. This choice is incorrect.

Choice B rationale:

While sodium intake can impact lithium levels, clients are usually advised to maintain a consistent, moderate sodium intake rather than adopting a low-salt diet. Extreme dietary changes can affect lithium levels and potentially lead to toxicity, making this choice inaccurate.

Choice C rationale:

Monitoring blood levels of lithium is crucial to ensure therapeutic effectiveness and prevent toxicity. During the initiation phase, frequent monitoring, typically weekly, is necessary to establish the appropriate dosage for each individual. Lithium has a narrow therapeutic range, and blood levels need to be closely regulated.

Choice D rationale:

Discontinuing lithium abruptly can lead to worsened bipolar symptoms. Diarrhea can contribute to dehydration and electrolyte imbalances, potentially impacting lithium levels, but stopping the medication is not the initial action to take. Adjustments in dosage or management strategies are usually explored before considering discontinuation.

Choice A rationale:

Telling the parents that they should not feel guilty might invalidate their emotions and discourage open communication. It's essential to acknowledge their feelings and address them empathetically.

Choice B rationale:

This choice demonstrates therapeutic communication and empathy. It encourages the parents to express their feelings, and the nurse is offering to listen and explore the reasons behind their guilt.

Choice C rationale:

This statement seems confrontational and may discourage the parents from sharing their emotions openly. Asking why they feel guilty immediately might put them on the defensive.

Choice D rationale:

While this statement acknowledges the difficulty of the situation, it ends with a premature reassurance that may not be well-received. The parents need space to discuss their feelings before focusing on the future.