The nurse is continuing to care for the client.
The nurse is providing teaching about lithium to the client and the client's adult child.
Select the 3 statements the nurse should include.
"Blurred vision is an expected adverse effect of this medication,"
"This medication can cause weight gain."
"This medication can cause nausea and drowsiness."
"It will take at least a week before this medication reaches a therapeutic level."
"You will be placed on a low-sodium diet while taking this medication."
Correct Answer : B,C,D
A. "Blurred vision is an expected adverse effect of this medication." Blurred vision is not a common or expected adverse effect of lithium. If this occurs, it may indicate toxicity or another underlying issue and should be reported. It is not part of routine education for expected side effects.
B. "This medication can cause weight gain." This is true. Weight gain is a known long-term adverse effect of lithium therapy and should be discussed with the client and family as part of monitoring and lifestyle considerations during treatment.
C. "This medication can cause nausea and drowsiness." These are common initial side effects when starting lithium and usually subside over time. Clients should be aware of these effects so they can differentiate between expected reactions and signs of toxicity.
D. "It will take at least a week before this medication reaches a therapeutic level." Correct. Lithium takes 7–14 days to reach therapeutic plasma levels, so clients may not experience symptom relief immediately. During this period, supportive care and safety monitoring are essential.
E. "You will be placed on a low-sodium diet while taking this medication." This is incorrect. Lithium has a narrow therapeutic index, and sodium levels affect lithium levels. A low-sodium diet can increase the risk of lithium toxicity, so clients should maintain a consistent sodium intake, not reduce it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Raise the head of the client's bed to a high-Fowler's position. A high-Fowler's position causes excessive hip flexion, which increases the risk of prosthetic dislocation after hip arthroplasty. Hip flexion should generally not exceed 90 degrees postoperatively.
B. Keep an abduction pillow between the client's legs. An abduction pillow maintains the leg in proper alignment and prevents internal rotation and adduction, which are common mechanisms of hip dislocation after surgery. It is a key intervention in protecting the surgical joint.
C. Elevate the client's affected leg on a pillow when in bed. Elevating the leg is appropriate for reducing swelling, but if not done correctly, it can cause improper hip positioning. It does not prevent dislocation unless combined with other alignment strategies.
D. Position the client's knees slightly higher than the hips when up in a chair. This position promotes hip flexion greater than 90 degrees, which increases the risk of dislocating the hip prosthesis. The hips should remain higher than the knees to prevent excessive flexion.
Correct Answer is A
Explanation
A. Choose a vein that is palpable and straight. A palpable, straight vein provides the best access for successful IV catheter insertion. It allows for easier threading of the catheter and reduces the risk of complications like infiltration.
B. Select a site on the client's dominant arm. The non-dominant arm is usually preferred to minimize interference with daily activities and reduce the risk of dislodgement due to frequent use.
C. Elevate the client's arm prior to insertion. Elevating the arm can decrease venous filling, making veins less prominent and harder to access. Instead, the arm should be placed in a dependent position to promote vein distention.
D. Apply a tourniquet below the venipuncture site. The tourniquet should always be placed above the insertion site to restrict venous return and make the veins more prominent and easier to access.
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