A nurse is reinforcing teaching with a client who has bipolar disorder and has a new prescription for lithium. To address possible adverse effects, the nurse should include that which of the following laboratory values will be monitored while the client is taking this medication?

Liver enzymes

Uric acid

Erythrocyte sedimentation rate

Sodium level

Answer and Explanation

The Correct Answer is D

A.   Monitoring liver enzymes (AST, ALT) is typically not directly related to lithium therapy. Elevated liver enzymes may indicate liver damage from various causes, such as hepatitis or medication toxicity, but it is not a routine monitoring parameter for lithium.
B.   Lithium can decrease the excretion of uric acid, potentially leading to elevated levels. Monitoring uric acid levels helps to detect hyperuricemia, which may contribute to conditions like gout. It's important to monitor this parameter periodically during lithium therapy.
C.   ESR is a nonspecific marker of inflammation and is not specifically monitored in relation to lithium therapy. It is used to diagnose or monitor conditions like infections, autoimmune diseases, or certain cancers, but it does not directly relate to lithium use.
D.   Monitoring serum sodium levels is crucial during lithium therapy because lithium can affect renal function and electrolyte balance, including sodium levels. Hyponatremia is a potential adverse effect of lithium, and regular monitoring helps detect and manage this condition promptly.

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Correct Answer is D

Explanation

A. Consuming alcohol close to bedtime can disrupt sleep patterns. While alcohol may initially induce drowsiness, it often leads to fragmented and poor-quality sleep later in the night. Therefore, advising the client to drink alcohol before bedtime is not recommended.
B. Taking long or late-afternoon naps can interfere with nighttime sleep patterns, especially for individuals experiencing insomnia or sleep disturbances related to depression. Napping can make it harder to fall asleep or stay asleep at night, thereby exacerbating sleep problems rather than improving them.
C. Eating a large or heavy meal just before bedtime can lead to discomfort, indigestion, and even heartburn, which can interfere with falling asleep and staying asleep. It's generally advisable to avoid heavy meals close to bedtime to promote better sleep quality.
D. Caffeine is a stimulant that can interfere with sleep. Consuming caffeinated beverages, especially in the afternoon or evening, can make it difficult for individuals with depression to fall asleep and can contribute to fragmented sleep. Limiting caffeine intake earlier in the day can help promote better sleep hygiene.

A. Buprenorphine B. Diazepam C. Varenicline D. Rimonabant

Correct Answer is B

Explanation

A. Buprenorphine is primarily used for the treatment of opioid dependence, not alcohol detoxification. It is a partial opioid agonist and can precipitate withdrawal symptoms in individuals dependent on opioids. Therefore, it is not appropriate for alcohol detoxification and would not typically be administered in this context.
B. Diazepam belongs to the benzodiazepine class of medications and is commonly used during alcohol detoxification. Benzodiazepines help manage symptoms of alcohol withdrawal, including anxiety, tremors, agitation, and seizures. They work by enhancing the effects of gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter in the brain. Diazepam has a longer duration of action and is preferred in managing alcohol withdrawal due to its smoother pharmacokinetic profile compared to shorter-acting benzodiazepines.
C. Varenicline is a medication used for smoking cessation. It works by partially activating nicotine receptors in the brain, reducing the pleasurable effects of smoking and decreasing withdrawal symptoms. It is not indicated for alcohol detoxification and would not be used in this context.
D. Rimonabant is a cannabinoid receptor antagonist that was once used for weight loss but has been withdrawn from the market due to psychiatric side effects, including depression and anxiety. It is not indicated for alcohol detoxification and would not be administered in this context.

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A nurse is reinforcing teaching with a client who has bipolar disorder and has a new prescription for lithium. To address possible adverse effects, the nurse should include that which of the following laboratory values will be monitored while the client is taking this medication?

Nursing Test Bank

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