A female client has been recently diagnosed as bipolar. She has taken lithium for the past several weeks to control mania. What must be included in client education regarding lithium toxicity?

Question

Options

• AMaintain a normal diet; however, limit salt intake to no more than 3 g/day.
• BTake lithium between meals to increase absorption.
• CWithhold lithium if experiencing diarrhea, vomiting, or diaphoresis.
• DFor pain or fever, avoid aspirin or acetaminophen (Tylenol). Nonsteroidal anti-inflammatory drugs

• A
  3% (1)
• B
  9% (3)
• C
  82% (27)
• D
  6% (2)

Explanation

(A) The client should maintain a normal diet including normal salt intake. A low-sodium diet can cause lithium retention, leading to toxicity. (B) Lithium must be taken with meals because it is irritating to the gastric mucosa. (C) Diarrhea, vomiting, or diaphoresis can cause dehydration, which will increase lithium blood levels. If these symptoms occur, the nurse should instruct the client to withhold lithium. (D) Lithium is not to be taken with over-the-counter drugs without specific instruction. Some drugs raise lithium levels, whereas others lower lithium levels.

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