A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

Eliminate use of nonsteroidal anti-inﬂammatory drugs. (NSAIDs)

Avoid consuming all foods that contain Iodine.

Notify healthcare provider prior to dental procedures.

Monitor blood glucose levels daily.

Answer and Explanation

The Correct Answer is A

Lithium carbonate is a mood stabilizer commonly used to treat bipolar disorder. However, it has a narrow therapeutic index and requires careful monitoring of serum levels to avoid toxicity. One of the major concerns with lithium therapy is the potential for drug interactions and toxicity. NSAIDs such as ibuprofen and naproxen can increase lithium levels by reducing its excretion and can lead to lithium toxicity. Therefore, it is essential to instruct the client to eliminate the use of NSAIDs while taking lithium.

Option b) Avoid consuming all foods that contain iodine is incorrect because iodine is not contraindicated with lithium. However, excessive iodine intake can interfere with thyroid function, which can exacerbate mood instability.

Option c) Notify healthcare provider prior to dental procedures is not specific to lithium therapy and is a general precaution that patients with bipolar disorder should follow before any medical or dental procedures.

Option d) Monitor blood glucose levels daily is also not directly related to lithium therapy. While lithium can cause diabetes insipidus, which can lead to excessive thirst and urination, it does not typically aﬀect blood glucose levels.

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Correct Answer is B

Explanation

Sumatriptan succinate is a medication used to treat migraine headaches by narrowing blood vessels in the brain. It is important to determine if the client has a history of coronary artery disease before administering the initial dose because the medication can also cause narrowing of the coronary arteries and potentially lead to a heart attack or other cardiac events.

Type 2 diabetes mellitus (a), seasonal allergic rhinitis (c), and irritable bowel syndrome (d) are not directly related to the use of sumatriptan succinate. However, it is still important to consider the client's medical history and overall health status when prescribing or administering any medication.

A. Advice the client that the medication should start to work in about 30 minutes. B. Administer a stool softener/laxative at the same time as the analgesic. C. Instruct the client to request assistance when ambulating to the bathroom. D. Tell the client to notify the nurse if the pain is not relieved.

Correct Answer is C

Explanation

The correct answer is C. Instruct the client to request assistance when ambulating to the bathroom.

Choice A reason:

Advise the client that the medication should start to work in about 30 minutes.

While it is important to inform the client about the onset of action of the medication, this is not the highest priority. Codeine, an opioid, can cause dizziness and sedation, which increases the risk of falls. Therefore, safety measures take precedence over informing the client about the medication’s onset time.

Choice B reason:

Administer a stool softener/laxative at the same time as the analgesic.

Opioids like codeine can cause constipation, so administering a stool softener or laxative is a good practice. However, this action is not the highest priority when considering the immediate safety of the client. Ensuring the client’s safety from potential falls due to dizziness or sedation is more urgent.

Choice C reason:

Instruct the client to request assistance when ambulating to the bathroom.

This is the correct answer because codeine can cause dizziness, sedation, and orthostatic hypotension, increasing the risk of falls. Ensuring the client requests assistance when moving can prevent potential injuries, making it the highest priority nursing action.

Choice D reason:

Tell the client to notify the nurse if the pain is not relieved.

While it is important for the client to communicate about the effectiveness of pain relief, this is not the highest priority. The immediate concern is the client’s safety due to the sedative effects of codeine. Therefore, preventing falls and injuries takes precedence.

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A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before administering initial dose of sumatriptan succinate to a client with a migraine headache, it is most to determine if the client’s history includes which problem?

Correct Answer is B

Explanation

Which nursing action had the highest priority when administering a dose of codeine with acetaminophen to a client?

Correct Answer is C

Explanation

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

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