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?

Choice A rationale:

"I'll take my medicine at bedtime because it will make me drowsy.”. This statement is not accurate and indicates a misunderstanding of the medication's effects. Methylphenidate, used to treat ADHD, is a stimulant medication and is not expected to cause drowsiness. Taking it at bedtime could interfere with the client's ability to sleep.

Choice B rationale:

"I need to tell my doctor if I start gaining weight.”. While it is important to report changes in weight to the healthcare provider, this statement does not indicate an accurate understanding of the medication's effects. Weight gain is not a typical side effect of methylphenidate, and this statement does not address the medication's primary purpose.

Choice C rationale:

"This medicine will help me relax and feel less anxious.”. This statement is incorrect as methylphenidate is not an anxiolytic medication. It is used to increase focus and reduce hyperactivity in individuals with ADHD. While some clients may experience a sense of calm as a result of improved focus, the primary purpose of the medication is not to reduce anxiety.

Choice D rationale:

"I know that I will be able to think more clearly now.”. This statement reflects an accurate understanding of the medication's effects. Methylphenidate is a central nervous system stimulant that can help individuals with ADHD improve their focus, attention, and cognitive function. Enhanced clarity of thought is one of the intended therapeutic effects of this medication. .

A nurse is planning care for a newly admitted client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan? The correct answer is choice B. Notify the client about designated times for meals.

Choice A rationale:

Weighing the client weekly for the first month is not an appropriate intervention in the initial care plan for a client with anorexia nervosa. While monitoring weight is essential, weekly weigh-ins may contribute to anxiety and distress in clients with eating disorders. The frequency of weigh-ins and the timing should be individualized based on the client's specific needs.

Choice B rationale:

Notifying the client about designated times for meals is a crucial intervention in the care plan for someone with anorexia nervosa. Establishing a structured meal schedule is important in promoting regular eating habits and preventing excessive exercise or other behaviors related to the disorder. Providing consistency in meal times can help the client regain control over their eating patterns.

Choice C rationale:

Negotiating with the client on how much weight she should gain each week is not a recommended approach in the initial stages of treatment for anorexia nervosa. Clients with this disorder often have distorted body image and unrealistic weight goals. It's important to set safe and appropriate weight gain goals based on the client's individual needs and in collaboration with a healthcare team, rather than negotiating arbitrary targets with the client.

Choice D rationale:

Decreasing the client's daily intake of fiber is not a suitable intervention in the care plan for anorexia nervosa. While dietary modifications may be necessary, reducing fiber intake can lead to constipation and other digestive issues. Any dietary changes should be made under the guidance of a registered dietitian or healthcare provider and should aim to restore a healthy and balanced diet.