An intoxicated client was admitted for trauma treatment last night at 2:00 a.m. (0200). When should the nurse expect to be alert for withdrawal symptoms?

Choice A reason:This is incorrect because water and salt do not convert lithium into a usable solute. Lithium is already a salt and is absorbed and distributed in the body without needing conversion.

Choice B reason:This is inaccurate because lithium does not compete with sodium chloride for receptor sites. Instead, lithium and sodium share similar renal excretion pathways, and sodium depletion can increase lithium reabsorption, leading to toxicity.

Choice C reason:This is correct because adequate salt and water intake help maintain stable lithium levels. Lithium is excreted by the kidneys, and dehydration or low sodium levels cause the kidneys to retain lithium, increasing the risk of toxicity. Maintaining hydration and normal sodium intake prevents dangerous fluctuations in serum lithium concentration.

Choice D reason:This is incorrect because lithium is not metabolized in the liver. It is excreted unchanged by the kidneys, so liver metabolism is not relevant to its clearance.

Choice A reason:This is incorrect because the nurse’s primary responsibility is to protect the client, not the male clients.

Choice B reason:This is inaccurate because the nurse’s intervention was not about stopping dancing but about addressing inappropriate exposure.

Choice C reason:This is incorrect because the nurse’s immediate action was not a teaching moment but a protective intervention. Teaching can occur later when the client is stable.

Choice D reason:This is correct because the nurse acted to protect the client’s dignity and minimize embarrassment. Clients with mania often lack awareness of socially inappropriate behavior, and the nurse’s intervention helps maintain safety and dignity without confrontation.