A nurse is reinforcing teaching with a client about a new prescription for lithium.
Which of the following statements should the nurse include in the teaching?

Your provider will prescribe a diuretic while you are taking lithium.

Weight gain is a manifestation of lithium toxicity.

We will need to check your lithium levels in the next 3 to 5 days.

Your lithium will be discontinued in 6 months to prevent addiction.

Answer and Explanation

The Correct Answer is C

Rationale for Choice A:

Diuretics are not routinely prescribed with lithium. While diuretics can increase the excretion of lithium, this can also lead to decreased lithium levels and potentially reduced effectiveness. Therefore, diuretics are generally only used in specific situations, such as when a client has lithium-induced edema or congestive heart failure. In such cases, the client's lithium levels would be closely monitored to ensure they remain within the therapeutic range.

Rationale for Choice B:

Weight gain is not a common manifestation of lithium toxicity. In fact, weight gain is a potential side effect of lithium therapy, but it is not typically associated with lithium levels reaching a toxic range. Other signs and symptoms of lithium toxicity include:

Tremor

Nausea and vomiting

Diarrhea

Confusion

Slurred speech

Ataxia

Seizures

Coma

Rationale for Choice C:

Monitoring lithium levels is essential to ensure that the client is receiving a therapeutic dose and to avoid toxicity. Lithium has a narrow therapeutic index, meaning that there is a small difference between the dose that is effective and the dose that is toxic. Regularly checking lithium levels allows the healthcare provider to adjust the dose as needed to maintain a safe and effective level.

The initial lithium level is typically checked within 3 to 5 days of starting the medication, and then periodically thereafter.

The frequency of monitoring may vary depending on the client's individual factors, such as age, kidney function, and other medications they are taking.

Rationale for Choice D:

Lithium is not typically discontinued after a specific period of time. It is often used as a long-term treatment for bipolar disorder to prevent the recurrence of manic and depressive episodes. The decision to discontinue lithium is made on a caseby-case basis, in consultation with the client and their healthcare provider.

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Correct Answer is A

Explanation

Choice A rationale:

I will contact my provider if I have difficulty urinating.

Chlorpromazine has anticholinergic effects, which can cause urinary retention. This means the medication can interfere with the normal function of the bladder, making it difficult to empty completely. Difficulty urinating can lead to bladder distention, urinary tract infections, and even kidney damage if left untreated.

It's crucial for the client to recognize this potential side effect and seek medical attention promptly if it occurs. Early intervention can help prevent complications and ensure proper bladder management.

By understanding this potential side effect and the importance of seeking help, the client demonstrates a grasp of the teaching provided.

Choice B rationale:

I might notice an increased frequency of my menstrual cycle.

Chlorpromazine does not typically affect menstrual frequency. While some antipsychotic medications can cause menstrual irregularities, chlorpromazine is not commonly associated with this effect.

If a client experiences changes in their menstrual cycle while taking chlorpromazine, it's important to discuss it with their healthcare provider to rule out other potential causes.

Choice C rationale:

These medications might cause breast tissue to atrophy.

Chlorpromazine is not known to cause breast atrophy. Breast atrophy, or shrinkage of breast tissue, can occur due to hormonal changes, aging, or certain medical conditions.

However, it's not a common side effect of chlorpromazine.

Choice D rationale:

I am at a decreased risk for infection while taking these medications.

Chlorpromazine does not decrease the risk of infection. In fact, it may slightly increase the risk of infection due to its potential to suppress the immune system.

It's essential for clients taking chlorpromazine to practice good hygiene and infection prevention measures to protect themselves from illness.

A. “You really should work hard to stay on the schedule we establish here.” B. “I wouldn’t worry about what you’ve done in the past. C. You’ll do just fine this time.” D. “Why do you find it difficult to take your medications if they improve your condition?”

Correct Answer is D

Explanation

The correct answer is Choice D.

Choice A rationale: Telling the client to work hard to stay on the schedule does not address the underlying reasons for the client's difficulty in following a medication regimen and may come off as dismissive.

Choice B rationale: Saying not to worry about the past does not acknowledge the client's concerns and may not provide practical assistance for future adherence.

Choice C rationale: Offering reassurance without addressing the client's past challenges does not provide a concrete plan for improving adherence.

Choice D rationale: Asking the client why they find it difficult to take medications opens a dialogue that allows the nurse to understand the client's specific barriers and to provide tailored strategies to improve adherence. This response is empathetic and solution-focused.

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A nurse is reinforcing teaching with a client about a new prescription for lithium. Which of the following statements should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a female client who is prescribed chlorpromazine. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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A nurse is reinforcing teaching with a client about a new prescription for lithium.
Which of the following statements should the nurse include in the teaching?