A nurse is collecting data from a client who is taking lithium. Which of the following findings should the nurse identify as early manifestations of lithium toxicity? (Select all that apply.)
Incoordination
Polyuria
Nausea
Convulsions
Confusion
Correct Answer : A,C,E
A. Incoordination, such as clumsiness or difficulty walking, can be an early sign of lithium toxicity. It reflects the neurological effects of elevated lithium levels on motor coordination.
B. Polyuria (excessive urination) is a common late symptom of lithium toxicity. Lithium interferes with the kidney's ability to concentrate urine, leading to increased urine output.
C. Nausea is a gastrointestinal symptom that can occur in the early stages of lithium toxicity. It is often accompanied by other gastrointestinal disturbances such as vomiting and diarrhea.
D. Convulsions (seizures) are not typically considered early manifestations of lithium toxicity but rather indicate severe toxicity. Seizures can occur at higher levels of lithium toxicity and require immediate medical intervention.
E. Confusion is another early sign of lithium toxicity. It reflects the impact of elevated lithium levels on the central nervous system, leading to cognitive impairment and altered mental status.
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Related Questions
Correct Answer is D
Explanation
A. Monitoring liver enzymes (AST, ALT) is typically not directly related to lithium therapy. Elevated liver enzymes may indicate liver damage from various causes, such as hepatitis or medication toxicity, but it is not a routine monitoring parameter for lithium.
B. Lithium can decrease the excretion of uric acid, potentially leading to elevated levels. Monitoring uric acid levels helps to detect hyperuricemia, which may contribute to conditions like gout. It's important to monitor this parameter periodically during lithium therapy.
C. ESR is a nonspecific marker of inflammation and is not specifically monitored in relation to lithium therapy. It is used to diagnose or monitor conditions like infections, autoimmune diseases, or certain cancers, but it does not directly relate to lithium use.
D. Monitoring serum sodium levels is crucial during lithium therapy because lithium can affect renal function and electrolyte balance, including sodium levels. Hyponatremia is a potential adverse effect of lithium, and regular monitoring helps detect and manage this condition promptly.
Correct Answer is A
Explanation
A. Diarrhea is a common symptom of opioid withdrawal. Opioids slow down gastrointestinal motility, so when their use is discontinued, it can lead to increased peristalsis and diarrhea. This occurs due to the rebound effect of the gastrointestinal tract.
B. Opioids typically cause pupil constriction (pinpoint pupils) when they are active in the body. During withdrawal, the opposite occurs, and pupils dilate (mydriasis). However, the question asks about withdrawal symptoms, not effects of opioid use, so this would not be expected in opioid withdrawal.
C. Bradycardia, or a slow heart rate, is not typically associated with opioid withdrawal. Instead, opioid withdrawal can cause tachycardia (rapid heart rate) due to the sympathetic nervous system activation that occurs during withdrawal.
D. Hypokinesis refers to decreased movement or activity, which is not a typical symptom of opioid withdrawal. Instead, opioid withdrawal often presents with symptoms such as restlessness, agitation, and muscle aches, which are indicative of hyperactivity rather than hypokinesis.
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