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.)

A. Thought-stopping is a cognitive behavioral technique used to interrupt and replace negative or distressing thoughts. However, it is not directly related to reminiscence therapy. Reminiscence therapy focuses on stimulating memories and promoting positive reflections on past experiences rather than blocking thoughts.
B. Creating a unit calendar can be a helpful strategy to promote orientation to time and events for older adults, especially those who may have memory impairments. While this is a valuable activity for maintaining orientation, it is not specifically reminiscence therapy. Reminiscence therapy involves recalling and discussing personal memories rather than focusing on current events.

C. Playing board games can indeed enhance cognition by stimulating various cognitive functions such as problem-solving, memory, and social interaction. However, it is not considered reminiscence therapy. Reminiscence therapy involves specific guided discussions or activities that evoke memories from the past, which can promote emotional well-being and socialization through shared experiences.
D. This is the most appropriate strategy for reminiscence therapy. Discussing childhood memories encourages older adults to recall and share past experiences, fostering a sense of identity, meaning, and connection. It can also enhance self-esteem and provide opportunities for social interaction within a therapeutic context.

A. Reaction formation is a defense mechanism where an individual expresses feelings or impulses that are the opposite of their anxiety-provoking unconscious feelings. For example, someone who harbors unconscious aggressive feelings might demonstrate exaggerated friendliness. However, this defense mechanism is more about behaviors and attitudes rather than physical manifestations.
B. Somatization is the conversion of psychological distress into physical symptoms. It involves experiencing physical symptoms, such as pain or illness, without a clear medical cause. This defense mechanism is common in individuals with anxiety disorders who may manifest their anxiety through physical complaints rather than acknowledging their emotional distress.
C. Sublimation involves channeling unacceptable impulses or emotions into socially acceptable behaviors. It does not typically involve physical manifestations but rather a redirection of emotions or impulses into constructive activities. For example, someone with aggressive impulses might channel them into sports or artistic pursuits.
D. Intellectualization is a defense mechanism where reasoning and logic are used to distance oneself from uncomfortable or threatening feelings. It involves focusing on facts and avoiding emotions associated with a situation. This mechanism is more cognitive and may involve discussing or analyzing anxiety-inducing situations in a detached, rational manner.