A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?
"This medication is addictive, so you will need to discontinue it in six months."
"Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."
"We will monitor your lithium levels closely while you are taking this medication."
"Weight gain should be reported to your provider as an indication of lithium toxicity."
The Correct Answer is C
A. Lithium is not considered addictive in the traditional sense, and it does not need to be discontinued after six months unless clinically indicated.
B. Diuretics are generally avoided in patients taking lithium due to the risk of lithium toxicity from altered renal clearance, rather than being a routine prescription for difficulty urinating.
C. Close monitoring of lithium levels is crucial to avoid toxicity and ensure therapeutic efficacy, making this statement correct and essential for the patient’s education.
D. While weight gain can occur with lithium therapy, it is not an indicator of lithium toxicity; symptoms of toxicity include nausea, tremors, and confusion rather than weight gain.
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Correct Answer is B
Explanation
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.
Correct Answer is A
Explanation
A. Sodium intake is crucial for clients on lithium, as low sodium levels can lead to lithium toxicity; therefore, maintaining a normal sodium level is important.
B. While potassium is important for general health, it does not specifically impact lithium levels.
C. Vitamin C is beneficial for overall health but does not have a direct relationship with lithium therapy.
D. Vitamin K is related to blood clotting and does not have a significant interaction with lithium treatment or its efficacy.