A client has been taking lithium 300 mg po bid for the past two weeks. This morning her lithium level was 1 mEq/L. The nurse should:

Question

Options

• ANotify the physician immediately
• BHold the morning lithium dose and continue to observe the client
• CAdminister the morning lithium dose as scheduled
• DObtain an order for benztropine (Cogentin)

• A
  16% (6)
• B
  8% (3)
• C
  74% (28)
• D
  3% (1)

Explanation

(A) There is no need to phone the physician because the lithium level is within therapeutic range and because there are no indications of toxicity present. (B) There is no reason to withhold the lithiumbecause the blood level is within therapeutic range. Also, it is necessary to give the medication as scheduled to maintain adequate blood levels. (C) The lab results indicate that the client's lithium level iswithin therapeutic range (0.2-1.4 mEq/L), so the medication should be given as ordered. (D) Benztropine is an antiparkinsonism drug frequently given to counteract extrapyramidal symptoms associated with the administration of antipsychotic drugs (not lithium).

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