A nurse is reviewing the laboratory report of a client who has bipolar disorder prior to the administration of lithium carbonate. The client's lithium level is.6 mEq/L.
Which of the following actions should the nurse take?
Assist the client to a left lateral position.
Implement fluid restrictions.
Request a dosage increase from the provider.
Prepare the client for hemodialysis.
The Correct Answer is C
- A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
- B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
- C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
- D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The nurse should include paresthesias as an adverse effect of ergotamine in the teaching.
Paresthesias refers to a sensation of tingling, tickling, prickling, or burning of a person’s skin with no apparent physical cause.
Choice A is wrong because blurred vision is not a commonly reported adverse effect of ergotamine.
Choice B is wrong because hematuria is not a commonly reported adverse effect of ergotamine.
Choice C is wrong because tinnitus is not a commonly reported adverse effect of ergotamine.
Correct Answer is A
Explanation
The correct answer is choice A. Increased pulse rate.
An aPTT of 90 seconds is much higher than the normal range of 30-40 seconds, which means the blood takes longer to clot and the client is at risk of bleeding. An increased pulse rate is a sign of blood loss and shock.
Choice B is wrong because increased blood pressure is not a sign of bleeding, but rather a sign of hypertension or stress.
Choice C is wrong because decreased temperature is not a sign of bleeding, but rather a sign of hypothermia or infection.
Choice D is wrong because decreased respiratory rate is not a sign of bleeding, but rather a sign of respiratory depression or sedation.
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