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
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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Related Questions
Correct Answer is D
Explanation
A. A level of 1.8 mEq/L is too high for initial treatment, as it is above the therapeutic range.
B. A level of 1.8 mEq/L is not within the maintenance treatment level, which is typically 0.6–1.2 mEq/L.
C. The level is above the therapeutic level, not below it.
D. A lithium level of 1.8 mEq/L is above the therapeutic range (0.6–1.2 mEq/L) and is considered toxic. Toxicity can lead to serious side effects like tremors, confusion, and renal dysfunction.
Correct Answer is B
Explanation
A. Potassium intake is not specifically important for the management of lithium therapy, though potassium levels should be monitored in some situations for general health.
B. Lithium is a mood stabilizer used to treat bipolar disorder, and it is important to maintain a consistent sodium intake. Lithium levels can be affected by changes in sodium levels, as low sodium levels can increase lithium toxicity.
C. Vitamin C is not directly related to lithium therapy and is not necessary for managing its effects.
D. Vitamin K does not have a significant role in lithium therapy and does not impact its effectiveness or toxicity.
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