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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Disorientation is a significant neurological finding that can signal a serious adverse reaction to lorazepam, particularly in older adults. It's crucial to report it immediately to the provider for prompt assessment and intervention.
Lorazepam, a benzodiazepine, can cause central nervous system (CNS) depression, which can manifest as disorientation, confusion, memory impairment, and even delirium.
Older adults are more vulnerable to CNS depressant effects due to age-related physiological changes, such as decreased metabolism and clearance of medications, as well as increased brain sensitivity.
Early identification and management of disorientation can prevent potential complications, such as falls, injuries, and worsening cognitive decline.
Choice B rationale:
Increased anxiety can be a paradoxical reaction to lorazepam, but it's not as immediately concerning as disorientation in terms of potential for serious harm.
The nurse should still monitor anxiety levels and report any significant changes to the provider, as dosage adjustments or alternative medications may be necessary.
Choice C rationale:
Blurred vision is a common side effect of lorazepam, but it's typically mild and transient.
It's important to assess the severity and duration of blurred vision and report it to the provider if it persists or interferes with daily activities.
Choice D rationale:
Anorexia, or loss of appetite, can be a side effect of lorazepam, but it's not as urgent as disorientation.
The nurse should monitor the patient's nutritional intake and weight, and report any significant changes to the provider.
Correct Answer is D
Explanation
Choice A rationale:
Increased salivation is a common side effect of haloperidol, but it is not the most serious adverse effect that the nurse should monitor for. It can be managed with medications such as anticholinergics, and it often subsides with continued use of haloperidol. Choice B rationale:
Serotonin syndrome is a rare but potentially life-threatening condition that can occur when haloperidol is combined with other medications that increase serotonin levels, such as antidepressants. However, it is not a direct adverse effect of haloperidol itself.
Choice C rationale:
Increased menstrual bleeding is not a known side effect of haloperidol.
Choice D rationale:
Tardive dyskinesia is a serious and potentially irreversible movement disorder that can occur as a long-term side effect of haloperidol and other antipsychotic medications. It is characterized by involuntary, repetitive movements of the face, tongue, and limbs.
The risk of tardive dyskinesia increases with the length of time that a person takes haloperidol and with the dose of the medication.
There is no cure for tardive dyskinesia, but the symptoms can sometimes be managed with medications.
It is important for nurses to monitor patients who are taking haloperidol for signs of tardive dyskinesia, so that the medication can be discontinued if necessary.
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