A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

Potassium 4.2 mEq/L

Sodium 136 mEq/L

Calcium 9.0 mg/dL

Creatinine 2.1 mg/dL

Answer and Explanation

The Correct Answer is D

A. Potassium 4.2 mEq/L is within the normal range (3.5–5.0 mEq/L).

B. Sodium 136 mEq/L is slightly low but does not warrant withholding lithium. However, sodium levels should be monitored regularly as low sodium increases the risk of lithium toxicity.

C. A calcium level of 9.0 mg/dL is within the normal range (8.5–10.2 mg/dL).

D. An elevated creatinine level (2.1 mg/dL) indicates possible renal dysfunction, which is a concern for lithium use. Lithium is excreted by the kidneys, and impaired renal function increases the risk of lithium toxicity.

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Correct Answer is B

Explanation

A. While gastrointestinal side effects are common with fluoxetine, they are not the priority concern in the context of bipolar disorder.

B. Fluoxetine (Prozac) is an SSRI used to treat depression, but in patients with bipolar disorder, it can trigger a manic episode. Therefore, the nurse's priority is to monitor for signs of mania, such as increased energy, euphoria, or impulsivity.

C. Administering the medication as ordered is essential, but the nurse must be vigilant for signs of mania, especially with SSRIs in bipolar patients.

D. Educating about weight gain is important but does not address the immediate risk of precipitating mania with fluoxetine in a bipolar patient.

A. "Come with me. Here is a milkshake to drink." B. "We need you to decide what activities you will do today C. "You will need to leave the dining room right now and go somewhere else to exercise." D. "You are already too thin and exercise is not good for you. Go sit down somewhere and eat something."

Correct Answer is A

Explanation

A. Offering the client a milkshake while directing them to a different activity provides a way to meet the client's nutritional needs and addresses their manic energy by giving them a focus other than exercise. This approach maintains structure without creating confrontation.

B. Giving the client the autonomy to decide on their activities might not be appropriate in acute mania, where impulsivity and poor judgment can lead to further disorganization.

C. Telling the client to leave the dining room immediately could escalate the situation, as it may be seen as an authoritative and disruptive intervention. A more supportive approach is better.

D. Telling the client that exercise is not good for them can escalate the situation or worsen their distress. It may also reinforce negative self-image and discourage further participation in necessary eating and nutrition.

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A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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