The nurse is providing medication teaching to a client with bipolar disorder who receives a prescription for lithium carbonate. Which instruction should the nurse emphasize with the client?

Avoid taking the medication on an empty stomach.

Maintain a fluid intake of 1,500 to 3,000 mL per day.

Report fluctuations in weight to the healthcare provider.

Keep medication fliers for frequent review and reference.

Answer and Explanation

The Correct Answer is B

A) Avoid taking the medication on an empty stomach:
While it’s generally recommended to take lithium carbonate with food or milk to minimize gastrointestinal side effects, taking it on an empty stomach does not pose a significant risk. Therefore, it is not the most crucial instruction to emphasize to the client.

B) Maintain a fluid intake of 1,500 to 3,000 mL per day:
This instruction is crucial because lithium can cause dehydration, especially if the client becomes dehydrated due to increased sweating or decreased fluid intake. Adequate fluid intake helps maintain stable lithium levels in the blood and reduces the risk of toxicity. Emphasizing the importance of maintaining hydration is essential for clients taking lithium.

C) Report fluctuations in weight to the healthcare provider:
Weight fluctuations can indicate changes in fluid balance or other metabolic effects of lithium. While it’s important for the client to report changes in weight, this instruction is not as critical as ensuring adequate fluid intake, which directly affects lithium levels and toxicity risk.

D) Keep medication fliers for frequent review and reference:
While it’s helpful for clients to have medication information for reference, this instruction is more about general medication adherence and education rather than a specific requirement related to lithium carbonate.

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Correct Answer is ["A","C","D"]

Explanation

A) Obtain a soft bristle toothbrush for the client:
This is an appropriate action because bleeding and tender gums can indicate oral bleeding, which may be exacerbated by the use of a standard toothbrush. Switching to a soft bristle toothbrush can help minimize trauma to the gums and reduce bleeding.

B) Provide a PRN nonsteroidal anti-inflammatory drug (NSAID) for gum discomfort:
Administering NSAIDs in this situation is not recommended. NSAIDs can further increase the risk of bleeding due to their antiplatelet effects. Therefore, providing an NSAID could exacerbate the client’s bleeding symptoms.

C) Review most recent coagulation lab values:
This is a crucial action to assess the client’s coagulation status and determine if the bleeding and bruising are related to anticoagulant therapy. Reviewing coagulation lab values, such as prothrombin time (PT) and international normalized ratio (INR), can provide important information about the client’s clotting function and guide further management.

D) Report findings to the healthcare provider:
This is essential to ensure timely evaluation and management of the client’s symptoms. Bleeding and bruising after anticoagulant therapy may indicate an increased risk of bleeding complications, and the healthcare provider needs to be informed promptly for further assessment and possible adjustment of the anticoagulant regimen.

E) Complete a medication variance report:
While documenting the client’s symptoms and actions taken is important for quality assurance and tracking adverse events, completing a medication variance report may not be the immediate priority in this situation. The focus should be on assessing the client’s condition, managing symptoms, and communicating with the healthcare provider for appropriate intervention

Correct Answer is ["1.7"]

Explanation

To find out how many mL the nurse should administer:

We can set up a proportion to solve for the unknown.

Given:

The prescription is for 1,000,000 units of penicillin G.

The available medication is 1,200,000 units/2 mL.

We can set up the proportion as follows:

1,000,000units/ xmL = 1,200,000units/2mL

Solving for x gives us the volume in mL that the nurse should administer.

Cross-multiplying and solving for x:

X = 1,000,000units×2mL/1,200,000units

After performing the calculation, we find that x equals 1.67 mL.

So, the nurse should administer 1.7 mL (rounded to the nearest tenth) of the medication.

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The nurse is providing medication teaching to a client with bipolar disorder who receives a prescription for lithium carbonate. Which instruction should the nurse emphasize with the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After receiving the third dose of a new oral anticoagulant prescription, an older client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

A client receives a prescription for penicillin G 1,000,000 units intramuscular (IM) daily. The medication is available in 1,200,000 units/2 mL syringe. How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Correct Answer is ["1.7"]

Explanation

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