A client with bipolar disorder taking lithium returns from a walk outside and reports feeling shaky and dizzy. The nurse suspects the client is experiencing a toxic reaction to the lithium and immediately notifies the:
Nurse manager.
Psychiatric nurse.
Psychiatrist.
Recreation therapist.
The Correct Answer is C
Choice A reason: The nurse manager is responsible for administrative oversight, staffing, and unit operations. While they may be informed of serious events, they are not the immediate clinical authority to address suspected lithium toxicity. Lithium toxicity is a medical emergency requiring physician intervention, not administrative management.
Choice B reason: The psychiatric nurse is skilled in monitoring mental health symptoms and providing therapeutic interventions. However, the psychiatric nurse does not have the authority to prescribe or adjust medications. While they can support the client and report findings, they cannot directly intervene in the pharmacological management of lithium toxicity.
Choice C reason: The psychiatrist is the correct person to notify because they are the prescribing provider responsible for managing the client’s medication regimen. Lithium toxicity can cause neurological and systemic complications such as tremors, dizziness, confusion, and even seizures. Immediate medical evaluation and possible discontinuation or adjustment of lithium are required. The psychiatrist can order serum lithium levels, initiate treatment such as IV fluids to enhance excretion, and determine whether hospitalization is necessary.
Choice D reason: The recreation therapist focuses on promoting psychosocial well-being through activities and leisure interventions. They do not have the medical expertise or authority to manage medication toxicity. Notifying them would not address the urgent clinical need of suspected lithium toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: The short-term goal focuses on immediate behavioral changes. Helping the client express feelings verbally, acknowledge manipulative behavior, and stop initiating arguments addresses the root of manipulation. These steps promote healthier communication and reduce maladaptive interactions.
Choice B reason: Sustaining lasting relationships is a long-term goal. While important, it cannot be achieved until the client learns to manage manipulative behaviors. Without addressing immediate communication and behavior, lasting relationships are unlikely to be maintained.
Correct Answer is B
Explanation
Choice A reason: Asking about reservations is open-ended but does not directly address the client’s concern. While it may encourage discussion, it does not provide therapeutic education about the role of therapy.
Choice B reason: This is the most therapeutic response because it explains the complementary roles of medication and therapy. Antidepressants correct neurochemical imbalances, but therapy addresses thought patterns, coping skills, and long-term behavioral change. This empowers the client with understanding and emphasizes the importance of combined treatment.
Choice C reason: Referring to insurance coverage is not therapeutic. It focuses on financial logistics rather than the clinical rationale for therapy.
Choice D reason: Suggesting that medication effects will not last forever may increase anxiety and resistance. It does not provide supportive education and may feel dismissive.
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