The nurse's teaching plan for a client taking lithium should include instructions to:
Maintain normal salt and fluid intake in the diet.
Drink twice the usual amount of fluids daily.
Avoid eating aged cheese, processed meats, and red wine.
Double the lithium dose if diarrhea or vomiting occurs.
The Correct Answer is A
Choice A Reason:
Maintaining normal salt and fluid intake is crucial for patients on lithium. Lithium can affect sodium levels in the body, and consistent sodium intake helps to keep lithium levels stable. Patients should be advised to drink adequate fluids to prevent dehydration but avoid excessive fluid intake, which could alter lithium levels and potentially lead to toxicity¹²³⁴.
Choice B Reason:
Drinking twice the usual amount of fluids daily is not recommended for patients on lithium unless directed by a healthcare provider. Excessive fluid intake can lead to changes in lithium levels and increase the risk of lithium toxicity. Patients should aim to consume a sufficient amount of fluids to stay hydrated, especially in situations that may lead to dehydration, such as during hot weather or illness.
Choice C Reason:
Avoiding aged cheese, processed meats, and red wine is generally advised for patients taking monoamine oxidase inhibitors (MAOIs), not lithium. These foods can contain high levels of tyramine, which can interact with MAOIs. However, there are no specific dietary restrictions for lithium regarding these foods. Patients should follow a balanced diet and consult with their healthcare provider for personalized dietary advice.
Choice D Reason:
Doubling the lithium dose if diarrhea or vomiting occurs is incorrect and potentially dangerous. If a patient experiences diarrhea or vomiting, it can affect lithium absorption and increase the risk of toxicity. Instead, patients should contact their healthcare provider for guidance. Adjustments to the medication regimen should only be made under medical supervision.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice a reason:
A history of allergy to iodine is a critical finding to report before a coronary angiography because the contrast dye used in the procedure typically contains iodine. Patients with an iodine allergy may experience severe reactions, including anaphylaxis, which can be life-threatening. Precautions such as premedication with steroids and antihistamines or the use of alternative contrast agents may be necessary.
Choice b reason:
A serum potassium level of 4.0 mEq/L is within the normal range, which is approximately 3.5 to 5.2 mEq/L for adults. Therefore, this finding is not significant and does not need to be reported to the healthcare provider prior to the procedure.
Choice c reason:
A blood pressure reading of 138/90 mmHg is slightly elevated but does not reach the threshold for stage 1 hypertension, which starts at 140/90 mmHg for individuals under 60 years of age. While it should be monitored, it is not an urgent concern that needs to be reported immediately before a coronary angiography unless the patient shows symptoms of hypertensive crisis.
Choice d reason:
An EKG showing atrial fibrillation is an important finding; however, it is not typically a contraindication for coronary angiography unless the patient is hemodynamically unstable or symptomatic. Atrial fibrillation can increase the risk of stroke, but anticoagulation management is usually the focus rather than postponing necessary diagnostic procedures.
Correct Answer is B
Explanation
Choice A reason:
Allowing the client some time alone could be beneficial in certain situations where the client prefers solitude to process their emotions. However, in the context of intimate partner abuse, leaving the client alone when they are visibly distressed may not provide the immediate support and safety they need.
Choice B reason:
Remaining with the client is crucial in providing emotional support and ensuring their safety. Victims of intimate partner abuse often feel isolated and scared; having a compassionate presence can offer comfort and reassurance. The nurse's presence can also help in assessing the client's immediate needs and risks, and in facilitating access to further support and resources.
Choice C reason:
Making an audio recording without the client's consent could be a violation of privacy and trust. It is essential to respect the client's autonomy and confidentiality, especially in sensitive situations involving abuse. The priority should be to address the client's emotional state and safety, not to gather evidence.
Choice D reason:
Encouraging the client to write down their thoughts can be a therapeutic tool and may be suggested as part of ongoing therapy or coping strategies. However, it should not be the first action taken when the client is in acute distress. Immediate emotional support and safety planning are more pressing concerns.
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