A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse that the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.)

Choice A reason: Monitoring daily weight can help detect early signs of lithium toxicity, as sudden weight gain may indicate fluid retention, which is a concern with lithium treatment. It is important for clients to monitor their weight regularly to ensure no significant fluctuations occur that could suggest adverse effects⁴.

Choice B reason: Avoiding foods with high tyramine content is not specifically related to lithium therapy. This dietary restriction is more commonly associated with monoamine oxidase inhibitors (MAOIs), a different class of psychiatric medications. Lithium does not interact with tyramine in the same way⁴.

Choice C reason: Limiting daily fluid intake is not recommended for clients taking lithium unless otherwise directed by a healthcare provider. Adequate fluid intake is essential to prevent dehydration, which can increase lithium levels and the risk of toxicity. Clients should maintain a consistent intake of fluids unless they have a condition that requires fluid restriction⁴⁵.

Choice D reason: Following a low sodium diet is not advised for clients on lithium therapy. Lithium is processed in the body similarly to sodium, so if sodium levels are too low, lithium retention may increase, leading to toxicity. Clients should maintain a consistent, adequate intake of sodium to prevent fluctuations in lithium levels⁴.

Choice A reason : Encouraging avoidance of anxiety-increasing situations may seem beneficial, but it can reinforce OCD behaviors. Avoidance prevents the client from learning how to cope with anxiety and can limit their ability to participate in daily activities⁴.

Choice B reason : Investigating what situations precipitate anxiety is a crucial step in managing OCD. Understanding the specific triggers can help in developing strategies to cope with and eventually reduce the anxiety associated with these situations. This approach is aligned with cognitive-behavioral therapy principles, which are effective in treating OCD⁴⁵.

Choice C reason : Teaching the client that compulsive behavior is excessive is part of psychoeducation. However, simply telling a client that their behavior is excessive without providing coping mechanisms can be unhelpful and may increase their anxiety. It's important to combine this with therapeutic techniques that help the client manage their compulsions⁴.

Choice D reason : Preventing the client from performing compulsive behavior abruptly can cause significant distress and may not be feasible or safe. Instead, treatment usually involves gradual exposure to anxiety-provoking situations and learning to resist the urge to perform compulsions, a technique known as exposure and response prevention (ERP)⁴.