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.

Answer and Explanation

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.

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Correct Answer is ["A","C","D"]

Explanation

Choice A Reason:

Stopping NSAIDs is crucial for clients with PUD because NSAIDs can cause injury to the lining of the stomach or intestine, making it more vulnerable to damage from stomach acid. This can lead to the development or exacerbation of ulcers.

Choice B Reason:

Continuing aspirin may not be advisable for clients with PUD, as aspirin is an NSAID and can contribute to the development of peptic ulcers by inhibiting prostaglandin synthesis, reducing the protective mucosal layer, and increasing susceptibility to injury.

Choice C Reason:

Limiting caffeine is recommended for clients with PUD. Caffeine stimulates gastric acid secretion, which can exacerbate ulcer symptoms and impede the healing process.

Choice D Reason:

Avoiding alcohol is advised for clients with PUD. While there is mixed evidence on alcohol directly causing stomach ulcers, heavy alcohol consumption is considered a risk factor for developing stomach ulcers and can worsen the symptoms of existing ulcers.

Choice E Reason:

Eating large meals is not recommended for clients with PUD. It is better to eat smaller, more frequent meals to avoid overfilling the stomach and increasing gastric pressure, which can exacerbate symptoms.

A. Bleeding and swelling cause increased pressure under the fascia. B. Displaced bones compress nerves and vessels. C. Blood supply to the bone is interrupted. D. Compression of the muscle tissue restricts blood flow to the area.

Correct Answer is A

Explanation

Choice A Reason
Acute compartment syndrome occurs when bleeding or swelling within an enclosed bundle of muscles – known as a muscle compartment – leads to increased pressure. This pressure can impede blood flow to the body tissue and destroy function. The fascia, which is a tough layer of fibrous tissue, does not stretch easily, so any swelling or bleeding can quickly lead to increased pressure.

Choice B Reason
While displaced bones can compress nerves and vessels, this is not the primary mechanism of acute compartment syndrome. Displaced bones are more likely to cause direct injury or impingement, but compartment syndrome specifically refers to the pressure build-up within a muscle compartment that affects circulation and tissue viability.

Choice C Reason
Interruption of blood supply to the bone is a serious concern and can lead to conditions such as avascular necrosis. However, in the context of acute compartment syndrome, the primary issue is the pressure within the muscle compartment rather than direct disruption of blood supply to the bone.

Choice D Reason
Compression of muscle tissue can restrict blood flow to the area, which is a part of the pathophysiology of compartment syndrome. However, the compression is a result of increased pressure within the compartment, not the primary cause. The increased pressure is due to bleeding and swelling, which is why choice A is the most accurate description.

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The nurse's teaching plan for a client taking lithium should include instructions to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge teaching for the client newly diagnosed with Peptic Ulcer Disease (PUD). The teaching should include instructions to: (Select all that apply)

Correct Answer is ["A","C","D"]

Explanation

A client who has developed acute compartment syndrome from a compound fracture of the arm asks the nurse to define what this means. Based on an understanding of the condition, the nurse should explain that:

Correct Answer is A

Explanation

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