When engaging with clients, which techniques should the nurse avoid using to foster more therapeutic responses? Select all that apply.

Choice A reason: Gastric lavage is typically not the first-line treatment for lithium toxicity due to the risk of aspiration and potential complications. It is usually reserved for cases where the ingestion was recent and massive.

Choice B reason: When a client presents with an extremely elevated lithium level, it is crucial to hold further doses to prevent exacerbation of toxicity. The nurse should monitor for early signs of toxicity, which include gastrointestinal symptoms like nausea, vomiting, diarrhea, and neurological symptoms such as tremors, confusion, and ataxia. The normal therapeutic range for lithium is 0.6 to 1.2 mmol/L, and levels above 1.5 mmol/L are considered toxic.

Choice C reason: While it is important to review the medication record, the immediate concern with an extremely elevated lithium level is addressing the toxicity. Checking the medication record can be part of the assessment process but is not the priority action.

Choice D reason: Administering the morning dose of lithium could worsen the client's condition by increasing the lithium level further, which is already extremely elevated. This could lead to severe toxicity or even fatal consequences.

Choice A reason: Ongoing communication with team members is crucial in managing care for clients with personality disorders, as it ensures consistency and support among caregivers.

Choice B reason: While solving clients' problems is a goal, it is not a technique to manage the nurse's frustration.

Choice C reason: Recognizing that behavior changes can occur quickly allows the nurse to adjust care plans promptly and may reduce frustration.

Choice D reason: It is not advisable to consider clients as personal friends, as this can blur professional boundaries and potentially lead to frustration.

Choice E reason: Discussing feelings of anger or frustration with colleagues can provide a support system for the nurse, helping to manage stress and prevent burnout.