Which instruction should the nurse give a client who is prescribed lithium carbonate (lithium)?

Maintain stable fluid intake.

Restrict salt.

Restrict fluid.

Exercise in hot weather.

Answer and Explanation

The Correct Answer is A

A. Lithium is excreted primarily by the kidneys, and its clearance can be affected by changes in fluid balance. It's important for clients taking lithium to maintain a stable and adequate fluid intake to help regulate lithium levels in the body. Stable fluid intake helps maintain electrolyte balance, which is crucial for the proper function of lithium and prevention of adverse effects.

B. Lithium can affect sodium reabsorption in the kidneys. High levels of sodium intake can alter lithium levels in the body, potentially leading to toxicity. Therefore, clients on lithium therapy are often advised to maintain a consistent and moderate level of sodium intake. Excessive dietary salt can interfere with lithium's therapeutic effects.

C. Restricting fluid intake is not recommended unless there are specific medical reasons to do so. Lithium therapy generally requires adequate hydration to maintain kidney function and prevent dehydration, which can affect lithium levels.

D. Exercising in hot weather can lead to increased sweating and fluid loss, which can potentially affect lithium levels by altering hydration status. However, the primary concern during exercise in hot weather is maintaining adequate hydration rather than restricting it.

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Correct Answer is D

Explanation

D. This goal addresses the immediate safety and well-being of the client. Depression, especially severe depression, can increase the risk of suicidal ideation and behaviors. It is crucial to ensure the client's safety and have measures in place for her to reach out for help if she feels overwhelmed or unsafe.

A. While this is an important goal for improving self-esteem and mood, it may not be the highest priority when the client's safety is at risk.

B. This goal focuses on future planning and motivation, which is important for recovery but may not be as urgent as ensuring immediate safety.

C. Understanding one's grief process is important for emotional healing, but it is not typically as critical as ensuring safety in the immediate term.

A. Loss of memory associated with sudden travel B. Adjustment of medication C. Monitoring of identities D. Reliving of traumatic events

Correct Answer is D

Explanation

D. Dissociative disorders, particularly post-traumatic stress disorder (PTSD) and acute stress disorder, can involve the reliving of traumatic events through flashbacks, nightmares, or intrusive memories.

Hospitalization may be required if the client experiences severe distress, is at risk of self-harm or harm to others during flashbacks.

A. Dissociative amnesia is characterized by significant memory loss that cannot be explained by ordinary forgetfulness. If a client experiences sudden travel and cannot remember how they arrived at a distant location, it could indicate dissociative amnesia. Hospitalization is not absolutely necessary.

B Dissociative disorders are primarily treated with psychotherapy rather than medication adjustments. However, if medication adjustments are necessary for co-occurring conditions or to manage symptoms like anxiety or depression, hospitalization is not necessary.

C. Monitoring of identities is typically done on an outpatient basis, unless there are additional complications or risks identified by a healthcare professional.

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Which instruction should the nurse give a client who is prescribed lithium carbonate (lithium)?

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