A nurse is preparing to administer valproic acid 500 mg PO. Available is valproic acid oral solution 250 mg/5 mL. How many mL should the nurse administer?
(Round the answer to the nearest whole number.)

Choice A rationale:

Withholding the dose if having a fine hand tremor is not recommended. Hand tremors are a common side effect of lithium, but they can be managed by adjusting the dose.

Choice B rationale:

Avoiding foods with a high tyramine content is not necessary for lithium users. This dietary restriction is typically associated with certain antidepressants, not lithium.

Choice C rationale:

Limiting daily fluid intake is incorrect. Lithium can cause increased thirst and urination, so it’s important to maintain adequate hydration.

Choice D rationale:

Following a low-sodium diet is not advised. Both salt and fluid can affect the levels of lithium in your blood, so it’s important to consume a steady amount every day.

So, the correct answer is, none of the above.

Choice A rationale:

Treating nasal rhinitis with an over-the-counter antihistamine is not directly related to neostigmine use or myasthenia gravis.

Choice B rationale:

If a medication dose is missed, wait until the next scheduled dose to take the medication is not the best advice. Neostigmine should be taken at regular intervals for maximum effectiveness.

Choice C rationale:

Expecting diaphoresis as a side effect of the neostigmine is not accurate. Diaphoresis is not a common side effect of neostigmine.

Choice D rationale:

Taking the medication 45 minutes before eating is correct. This timing helps maximize the medication’s effectiveness during meals, when muscle strength for swallowing is crucial.

So, the correct answer is,

D.