A nurse in a community mental health clinic is assessing a client who began taking lithium carbonate 5 days ago. The client reports fine hand tremors and has a current lithium level of 1.2 mEq/L. Which of the following actions should the nurse take?

To find out how many mL the nurse should administer for the total daily dose, we need to calculate the total daily dose and then convert it to mL using the available concentration.

The client is prescribed hydroxyzine 60 mg PO every 8 hours. To find the total daily dose, we can first calculate the dose per day and then convert it to mL.

Dose per day = Dose per dose interval x Number of doses per day

Dose per day = 60 mg x 3 (every 8 hours)

Dose per day = 180 mg per day

Now, we need to convert this dose to mL using the available concentration:

Concentration: 10 mg/5 mL

To find out how many mL for 180 mg, we can set up a proportion:

(10 mg / 5 mL) = (180 mg / x mL)

Cross-multiply:

10 mg * x mL = 5 mL * 180 mg

Now, solve for x (the number of mL):

x mL = (5 mL * 180 mg) / 10 mg

x mL = 900 mL / 10 mg

x mL = 90 mL

So, the nurse should administer 90 mL for the total daily dose.

A. Summarize the objectives the client achieved during the relationship:
This intervention is more appropriate for the termination phase of the nurse-client relationship. During termination, the nurse summarizes the progress made, goals achieved, and skills learned during the therapeutic relationship. This helps both the nurse and the client reflect on the journey and celebrate accomplishments.

B. Present issues regarding confidentiality:
Discussing confidentiality is crucial and typically occurs in the orientation phase of the nurse-client relationship. Establishing trust and clarifying the boundaries of confidentiality early in the relationship helps the client feel secure and promotes open communication. This choice is relevant during the initial stages of the therapeutic relationship.

C. Promote the client's problem-solving skills:
This is the correct choice for the working phase of the nurse-client relationship. In this phase, the focus is on active problem-solving, exploring feelings and thoughts, and encouraging the client to develop coping strategies. The nurse supports the client in identifying problems, generating solutions, and implementing effective strategies. Promoting the client's problem-solving skills is a central aspect of therapeutic work during this phase.

D. Identify the responsibilities of the client and nurse:
Clarifying the responsibilities of both the client and nurse is essential to establish clear roles and expectations. This usually occurs in the orientation phase. During this phase, the nurse explains the purpose of the therapeutic relationship, the roles of both parties and the boundaries of the nurse-client interaction. Establishing clear responsibilities helps create a foundation for a respectful and effective therapeutic alliance.