A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

A. "Notify your provider if you develop a fever while taking this medication."
Clozapine is an antipsychotic medication used to treat severe mental illnesses like schizophrenia. One of the potentially serious side effects of clozapine is agranulocytosis, which is a significant drop in white blood cell count. This can lead to an increased risk of infection. If the client develops a fever, it could be an early sign of an infection due to the lowered white blood cell count, so it's important for them to notify their provider promptly.
B. "Ringing in the ears is an expected adverse effect of this medication." - Tinnitus (ringing in the ears) is not a commonly reported adverse effect of clozapine.
C. "You might experience weight loss while taking this medication." - Weight gain is actually more commonly associated with clozapine use, rather than weight loss.
D. "Diarrhea is a common adverse effect of this medication." - While gastrointestinal disturbances can occur as side effects of antipsychotic medications, diarrhea is not specifically known as a common adverse effect of clozapine.

A. Hypomagnesemia:
Correct Answer: This electrolyte imbalance is the one the nurse should assess the client for.
Explanation: Lithium is primarily excreted by the kidneys, and its excretion can be influenced by factors that affect renal function, including electrolyte imbalances. Hypomagnesemia (low magnesium levels) can potentially reduce the excretion of lithium, leading to increased lithium levels in the blood. This can increase the risk of lithium toxicity, which can be dangerous. Therefore, monitoring magnesium levels is important in clients taking lithium.
B. Hyponatremia:
Incorrect Explanation: While hyponatremia (low sodium levels) is a potential concern, it is not as directly linked to lithium interaction as hypomagnesemia.
Explanation: Lithium can cause diabetes insipidus, which leads to excessive urination and subsequent loss of water and electrolytes, including sodium. However, hyponatremia is not the immediate electrolyte imbalance that arises due to the interaction with lithium.
C. Hypocalcemia:
Incorrect Explanation: Hypocalcemia (low calcium levels) is not a primary concern in the context of lithium use.
Explanation: Lithium does not have a direct interaction with calcium levels. Hypocalcemia is typically not a result of lithium use or its interaction with other factors.
D. Hypokalemia:
Incorrect Explanation: While electrolyte imbalances like hypokalemia (low potassium levels) can have health implications, it is not the primary electrolyte imbalance to be concerned about with lithium use.
Explanation: Hypokalemia is not a direct consequence of lithium interaction. Monitoring potassium levels is important for overall health, but it's not the primary electrolyte imbalance associated with lithium use and its potential interactions.