A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

He will monitor your lithium levels closely while you are taking this medication."

This medication is addictive, so you will need to discontinue it in six months."

"Weight gain should be reported to your provider as an indication of lithium toxicity."

"Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Answer and Explanation

The Correct Answer is A

Lithium is a commonly used medication for treating bipolar disorder, and therapeutic drug monitoring is crucial to ensure its effectiveness and prevent potential toxicity. Monitoring the client's lithium levels in the blood is important because lithium has a narrow therapeutic range, meaning that levels that are too low might not provide the desired therapeutic effect, while levels that are too high can lead to toxicity.

B) "This medication is addictive, so you will need to discontinue it in six months."

Lithium is not considered addictive. It's important to provide accurate information about the nature of the medication to avoid unnecessary concerns.

C) "Weight gain should be reported to your provider as an indication of lithium toxicity."

While weight gain can be a side effect of some medications, it's not a specific indicator of lithium toxicity. Lithium toxicity is characterized by a range of symptoms including tremors, confusion, nausea, vomiting, and excessive thirst, among others.

D) "Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Diuretics are generally not recommended with lithium because they can increase the risk of lithium toxicity. Lithium can affect kidney function, and using diuretics may exacerbate this effect. The client should be advised not to use diuretics without consulting their healthcare provider.

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Correct Answer is C

Explanation

A. A pretreatment electroencephalogram (EEG) will be done.

An EEG is not typically necessary when starting valproate for bipolar disorder. EEGs are more commonly used to assess brain activity in the context of epilepsy.

B. High serum sodium levels can cause toxic levels of valproate.

Sodium levels are not directly related to the toxic levels of valproate. The primary concern with valproate is its impact on liver function and potential for hepatotoxicity.

C. Liver function tests must be monitored.

Explanation: Valproate is an antiepileptic and mood-stabilizing medication commonly used to treat bipolar disorder. One of the potential side effects of valproate is hepatotoxicity (liver damage). Therefore, monitoring liver function tests (such as serum transaminases) is important to assess the medication's impact on the liver and to ensure the client's safety.

D. Thyroid function tests should be performed every 6 months.

While thyroid function tests might be important for some medications, monitoring thyroid function is not a primary consideration when using valproate. The main focus with valproate is on liver function monitoring.

A. You are being unreasonable, and I will not call your doctor at this hour." B. Go back to your room, and I'll try to get in touch with your doctor." C. You must be very upset about something D. I can't call a doctor in the middle of the night unless it's an emergency."

Correct Answer is C

Explanation

A. "You are being unreasonable, and I will not call your doctor at this hour."

This response is confrontational and dismissive of the client's request. It does not promote a therapeutic interaction and might escalate the situation.

B. "Go back to your room, and I'll try to get in touch with your doctor."

This response might temporarily calm the client, but it’s misleading if the nurse does not intend to call the doctor. It also avoids addressing the client's immediate emotional needs and could result in a loss of trust if the nurse doesn’t follow through.

C. "You must be very upset about something."

This is the most therapeutic response. It acknowledges the client’s feelings without judgment and opens up communication. It allows the nurse to explore the client’s concerns, which is essential in providing appropriate care and support in a psychiatric setting.

D. "I can't call a doctor in the middle of the night unless it's an emergency."

While this statement is factually correct, it can come across as dismissive and could escalate the client's agitation. It does not acknowledge the client's emotions and might make the client feel that their concerns are not being taken seriously.

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A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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