Which laboratory value must be monitored frequently for the client who is on Lithium therapy?

Choice A rationale: The AIMS Scale refers to the Abnormal Involuntary Movement Scale and is used in the assessment of patients for the presence of involuntary movements across body regions. The score ranges from zero which denotes the absence of dyskinesia and four which stands for severe, maximal amplitude and persistence of the abnormal movements during the examination period. It is also used to monitor clients with tardive dyskinesia.
Choice B rationale: the Hamilton scale is a multiple-item questionnaire used in the assessment of clients for depression and provides a guide for patient recovery evaluation.
Choice C rationale: the Braden Scale is used in the assessment of clients for the risk of pressure ulcers.
Choice D rationale: the Morse Scale is a Fall Risk Assessment tool used in assessing the probability of a client sustaining a fall.

Choice A rationale: Both sodium and chloride are important for fluid balance but chloride has no effect on the blood lithium levels.
Choice B rationale: sodium has an effect on the blood lithium levels by competing with lithium for reabsorption in the kidneys but vitamins do not influence the lithium levels in blood.
Choice C rationale: dehydration increases the risk of lithium toxicity since it will result in oliguria hence increasing the risk of lithium toxicity since the drug is primarily excreted in urine. Sodium and lithium compete for reabsorption in the kidneys, so low sodium levels can increase lithium retention and lead to toxicity. Therefore, the client should maintain an adequate intake of sodium and water to prevent dehydration and sodium loss and to keep the lithium level within the therapeutic range.
Choice D rationale: water has an influence on blood lithium levels since adequate intake minimizes the risk of toxicity by increasing the drug’s excretion in urine.
However, potassium does not compete with lithium for reabsorption.