A nurse in a mental health facility is reviewing the laboratory results of a client who is taking lithium carbonate.
Which of the following findings places the client at risk for lithium toxicity?

Aspartate aminotransferase 40 units/L.

WBC 6,000/mm3.

Sodium 132 mEq/L.

Calcium 10.0 mg/dL.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Aspartate aminotransferase (AST) is not directly related to lithium toxicity. Elevated AST levels are indicative of liver dysfunction or damage, not lithium toxicity.

Choice B rationale:

White blood cell (WBC) count within the normal range (6,000/mm3) is not a specific indicator of lithium toxicity. It is essential to focus on electrolyte and renal function parameters when assessing lithium toxicity.

Choice C rationale:

Low serum sodium levels (132 mEq/L) can place the client at risk for lithium toxicity. Hyponatremia, often caused by lithium-induced nephrogenic diabetes insipidus, can lead to impaired lithium excretion and increased risk of toxicity.

Choice D rationale:

A calcium level of 10.0 mg/dL is within the normal range and is not directly associated with lithium toxicity. Lithium toxicity primarily affects sodium levels, as mentioned earlier.

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Correct Answer is C

Explanation

Choice A rationale:

"I'm struggling with altered motor function.”. This statement is more in line with a description of conversion disorder or functional neurological symptom disorder, where clients may experience symptoms like paralysis or altered motor function, but these symptoms are typically not intentionally produced for attention-seeking purposes.

Choice B rationale:

"I don't know why I'm feeling this way.”. This statement does not specifically indicate a deliberate intent to falsify psychological symptoms for attention. It could be related to other emotional or psychological issues, but it doesn't directly relate to the behavior described in the question.

Choice D rationale:

"I'm worried about having a serious illness.”. This statement reflects concerns about actual medical conditions and does not align with the behavior of repeatedly falsifying psychological symptoms for attention. People with factitious disorder may feign physical symptoms but not necessarily express concerns about having a serious illness themselves. Now, let's address the last question.

A. Withhold the next dose of the medication. B. Ask the client about a recent change in laundry detergent. C. Apply hydrocortisone cream on the client's rash. D. Explain that the medication causes a temporary rash.

Correct Answer is A

Explanation

The correct answer is: A. Withhold the next dose of the medication.

Choice A rationale: Lamotrigine can cause serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Any rash should be taken seriously, and the medication should be withheld immediately to prevent potential severe reactions1.

Choice B rationale: While a change in laundry detergent could cause a rash, it is less likely to be the cause if the rash appeared after starting lamotrigine.

Choice C rationale: Applying hydrocortisone cream may help with mild skin irritations, but it does not address the potential severity of a drug-induced rash.

Choice D rationale: Explaining that the medication causes a temporary rash is not appropriate without first assessing the severity of the rash and withholding the medication.

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A nurse in a mental health facility is reviewing the laboratory results of a client who is taking lithium carbonate.Which of the following findings places the client at risk for lithium toxicity?

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A nurse in a mental health facility is reviewing the laboratory results of a client who is taking lithium carbonate.
Which of the following findings places the client at risk for lithium toxicity?