A nurse is contributing to the plan of care for a client who has a new prescription for lithium. Which of the following interventions should the nurse recommend?

Decrease the client's dietary potassium.

Increase the client's daily caloric intake.

Monitor the client for hypoglycemia.

Administer the medication with meals.

Answer and Explanation

The Correct Answer is D

A.   Lithium can affect sodium and potassium balance in the body, but it does not specifically require a decrease in dietary potassium. Instead, sodium intake should be kept consistent because lithium excretion is influenced by sodium levels. Therefore, decreasing dietary potassium is not a recommended intervention.
B.   Lithium can sometimes cause weight gain as a side effect. Increasing daily caloric intake is not a standard intervention when starting lithium. Clients should be encouraged to maintain a balanced diet and regular exercise regimen to manage potential weight changes.

C.   Hypoglycemia is not a common side effect of lithium. Therefore, monitoring for hypoglycemia is not necessary when a client is taking lithium.
D.   Administering lithium with meals can help reduce gastrointestinal side effects, such as nausea and upset stomach, which are common when starting the medication. It also helps with consistent absorption and reduces the peak serum concentration of lithium, which can minimize side effects and stabilize blood levels.

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Correct Answer is B

Explanation

A. Obsessive behaviors, such as repetitive actions or fixations on specific thoughts or tasks, can be indicative of delirium. Delirium often manifests with altered behavior patterns that are unusual for the individual, including obsessive or compulsive-like behaviors that are not typical of their baseline mental status. However, this is not specific to delirium.
B. Fluctuating orientation, where the client is sometimes alert and oriented and at other times confused or disoriented, is a hallmark of delirium. Unlike dementia, which typically presents with a more steady decline in cognitive function, delirium is characterized by rapid changes in mental status over hours to days. This fluctuation is important to note as it strongly suggests delirium rather than other chronic cognitive impairments.
C. Gradual memory loss reported by family members is more suggestive of chronic conditions such as dementia rather than delirium. Delirium, in contrast, is characterized by acute onset and fluctuating course rather than a gradual decline in cognitive abilities over time.
D. Depression can coexist with delirium, but a consistent state of depression without acute changes in mental status is less indicative of delirium. Delirium is characterized by rapid changes in cognition and behavior rather than a persistent mood disorder. Therefore, while depression should be assessed and managed appropriately, it is not typically a sign of delirium unless there are acute changes in mental status accompanying it.

A. Risperidone B. Bupropion C. Aripiprazole D. Quetiapine

Correct Answer is B

Explanation

A. Risperidone is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. It is not indicated for smoking cessation and does not have any direct effect on nicotine withdrawal or cravings. Therefore, it would not be included in discussions about smoking cessation medications.
B. Bupropion is a medication that is FDA-approved for smoking cessation. It works by reducing nicotine cravings and withdrawal symptoms. It is available in sustained-release formulations specifically marketed for smoking cessation under the brand name Zyban. Bupropion can be effective in helping individuals quit smoking and is often recommended as a first-line treatment.
C. Aripiprazole is an antipsychotic medication used primarily to treat conditions such as schizophrenia, bipolar disorder, and major depressive disorder. It does not have any specific indication or role in smoking cessation. Therefore, it would not typically be included in discussions about medications for quitting smoking.
D. Quetiapine is another antipsychotic medication used to treat conditions like schizophrenia, bipolar disorder, and major depressive disorder. Similar to aripiprazole and risperidone, it does not have any direct role in smoking cessation. It is not indicated for reducing nicotine cravings or aiding in smoking cessation efforts.

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A nurse is contributing to the plan of care for a client who has a new prescription for lithium. Which of the following interventions should the nurse recommend?

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