A nurse is preparing an in-service for an annual skills fair at a community medical facility about fire safety. Place the steps in the order in which they should be performed in the case of a fire emergency. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

A. Liver function tests: While lithium can affect liver function in some cases, routine liver function tests are not typically required before administering lithium. These tests are more relevant for medications metabolized by the liver.
B. Thyroid hormone assay: This is the correct action. Regular monitoring of thyroid function, including thyroid hormone levels, is essential for clients taking lithium, as lithium therapy can lead to hypothyroidism or exacerbate preexisting thyroid conditions. Checking thyroid function before administering lithium helps ensure the client's thyroid status is within the therapeutic range and identifies any abnormalities that may require intervention.
C. Erythrocyte sedimentation rate (ESR): ESR is a nonspecific marker of inflammation and is not directly relevant to monitoring lithium therapy. While lithium can affect renal function and electrolyte balance, ESR does not specifically assess these parameters.
D. Brain natriuretic peptide (BNP): BNP is a marker of cardiac function and is not routinely monitored in clients taking lithium. While lithium can have cardiovascular effects, routine BNP testing is not necessary before administering lithium. Monitoring for cardiovascular side effects of lithium typically involves assessing for symptoms such as arrhythmias or changes in blood pressure and heart rate.

A. Hypocalcemia: Hypocalcemia, or low levels of calcium in the blood, is not typically associated with an increased risk of urolithiasis. In fact, hypercalcemia, or high levels of calcium, is more commonly linked to the formation of calcium-based kidney stones.
B. Diuretic use: Diuretic medications can increase urine production and may contribute to dehydration, which can predispose individuals to the formation of kidney stones. However, diuretic use alone is not as significant a risk factor as other factors like dehydration or specific dietary habits.
C. Family history: Family history of urolithiasis is a significant risk factor for developing kidney stones. Genetic factors can influence the likelihood of stone formation, and individuals with a family history of kidney stones are at a higher risk of experiencing them themselves.
D. BMI less than 25: Obesity and higher BMI (body mass index) are associated with an increased risk of urolithiasis. Excess body weight can lead to metabolic changes that promote the formation of kidney stones. Therefore, having a BMI less than 25 is less likely to be a risk factor compared to having a higher BMI.