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 D
Explanation
A. Galantamine is a reversible acetylcholinesterase inhibitor and would not be effective in treating a cholinergic crisis.
B. Physostigmine is also a reversible acetylcholinesterase inhibitor and would not be suitable for reversing a cholinergic crisis.
C. Flumazenil is a benzodiazepine antagonist used to reverse benzodiazepine effects, not cholinergic crises.
D. Atropine is an anticholinergic medication that is effective in reversing the effects of excessive acetylcholine during a cholinergic crisis, making it the appropriate choice in this situation.
Correct Answer is A
Explanation
A. Asthma is a contraindication for cholinergic medications because these drugs can cause bronchoconstriction and may exacerbate respiratory conditions. Careful assessment is necessary before administration to ensure safety.
B. Hypertension is not a direct contraindication for cholinergic medications; they may not significantly affect blood pressure in most cases.
C. Alzheimer's disease is not a contraindication for cholinergic medications; in fact, cholinergic agents may be used to improve cognitive function in some patients with dementia.
D. Diarrhea is not a contraindication for cholinergic medications but may indicate excessive cholinergic activity; it should be monitored, but it does not prevent administration.