A patient on lithium therapy presents to the emergency department. When should you hold the lithium medication and notify the healthcare provider?
A lithium lab level of 0.9 mEq/L
When the patient complains of dry mouth and increased thirst
When the patient reports mild hand tremors
When the patient has symptoms such as nausea, vomiting, diarrhea, and coarse tremors
The Correct Answer is D
Choice A reason: A lithium level of 0.9 mEq/L is within the therapeutic range (0.6–1.2 mEq/L). This does not require holding the medication.
Choice B reason: Dry mouth and increased thirst are common side effects of lithium due to its mild diuretic effect. These do not indicate toxicity and do not require holding the medication.
Choice C reason: Mild hand tremors are a common side effect of lithium and are not usually dangerous. They can be managed but do not warrant stopping the medication.
Choice D reason: Nausea, vomiting, diarrhea, and coarse tremors are signs of lithium toxicity. These symptoms indicate dangerous accumulation of lithium in the body, requiring immediate discontinuation and notification of the healthcare provider.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: A lithium level of 0.9 mEq/L is within the therapeutic range (0.6–1.2 mEq/L). This does not require holding the medication.
Choice B reason: Dry mouth and increased thirst are common side effects of lithium due to its mild diuretic effect. These do not indicate toxicity and do not require holding the medication.
Choice C reason: Mild hand tremors are a common side effect of lithium and are not usually dangerous. They can be managed but do not warrant stopping the medication.
Choice D reason: Nausea, vomiting, diarrhea, and coarse tremors are signs of lithium toxicity. These symptoms indicate dangerous accumulation of lithium in the body, requiring immediate discontinuation and notification of the healthcare provider.
Correct Answer is A
Explanation
Choice A reason: Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly associated with sexual dysfunction, including decreased libido, delayed orgasm, or erectile difficulties. This is an important teaching point because it can affect adherence to therapy if the client is not prepared for this side effect.
Choice B reason: Drooling is not a typical side effect of fluoxetine. Excessive salivation is more commonly seen with antipsychotics such as clozapine, not SSRIs.
Choice C reason: Improvement in depressive symptoms with fluoxetine usually takes 2 to 4 weeks, not 2 to 3 days. Clients should be counseled to continue taking the medication consistently and not expect immediate relief.
Choice D reason: Appetite changes can occur with SSRIs, but decreased appetite is not a primary or consistent side effect of fluoxetine. Some clients may experience weight changes, but sexual dysfunction is more characteristic.
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