Which instruction should the nurse give a client who is prescribed lithium carbonate (lithium)?

Maintain stable fluid intake.

Restrict salt.

Restrict fluid.

Exercise in hot weather.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is B

Explanation

B. Conversion disorder involves the presence of neurological symptoms that are inconsistent with known neurological or medical conditions. These symptoms often manifest as sensory or motor deficits, such as blindness, paralysis, or seizures, without a clear organic basis. The symptoms are not intentionally produced and are not explained by another medical or psychiatric condition.

A. Hypochondriasis, now known as illness anxiety disorder, involves excessive worry or preoccupation with having a serious illness despite medical reassurance and lack of significant physical symptoms. It does not typically involve sensory or neurological symptoms such as blindness.

C. Malingering involves the intentional production or exaggeration of symptoms for secondary gain, such as financial compensation, avoiding military duty, or obtaining drugs. In malingering, there is typically a clear external incentive for the behavior, which is not evident in the soldier's case.

D. Somatization disorder (now termed somatic symptom disorder) involves multiple and recurrent physical symptoms that are distressing and lead to excessive thoughts, feelings, and behaviors related to these symptoms. It does not typically present with sudden onset of sensory deficits like blindness.

A. The client will identify positive qualities about herself. B. The client will identify ways to achieve a reachable goal for the future. C. The client will identify her position in the grief process. D. The client will contact a staff member when she feels she might hurt herself.

Correct Answer is D

Explanation

D. This goal addresses the immediate safety and well-being of the client. Depression, especially severe depression, can increase the risk of suicidal ideation and behaviors. It is crucial to ensure the client's safety and have measures in place for her to reach out for help if she feels overwhelmed or unsafe.

A. While this is an important goal for improving self-esteem and mood, it may not be the highest priority when the client's safety is at risk.

B. This goal focuses on future planning and motivation, which is important for recovery but may not be as urgent as ensuring immediate safety.

C. Understanding one's grief process is important for emotional healing, but it is not typically as critical as ensuring safety in the immediate term.

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Which instruction should the nurse give a client who is prescribed lithium carbonate (lithium)?

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