RN Nursing · Mood-Stabilizing Medications · Practice question
Select the 3 statements the nurse should include.
52-Year-Old Client in Emergency Department — Psychiatric Presentation
Nurses' Notes
Day 1, 0900: A 52-year-old client brought to emergency department by adult child. Client is alert and oriented to person and time but does not know where they are. No history of substance use according to client's adult child. Client exhibits constant movements and poor concentration. Hair and clothing are unclean. Appears to be listening to unseen others. Skin turgor poor. Day 1, 0915: The client's adult child reports the client has not slept for 2 days and has become obsessed with cleaning the house and hosting parties. At times the client is overly joyous and has a very elevated sense of self-confidence. The adult child states that the client has also demonstrated very impulsive spending habits and expresses concern about the client giving away large sums of money to others. The client's speech is very pressured, disorganized, and loud. Client unable to recall the last time they ate.Vital Signs
Day 1, 0905: Temperature 37.1° C (98.8° F) Heart rate 120/min Respiratory rate 19/min Blood pressure 138/88 mm Hg Oxygen saturation 98% on room airHistory and Physical
A 52-year-old client brought to emergency department by adult child. Client is alert and oriented to person and time but does not know where they are. No history of substance use according to client's adult child. Client exhibits constant movements and poor concentration. Hair and clothing are unclean. Appears to be listening to unseen others. Skin turgor poor. The client's adult child reports the client has not slept for 2 days and has become obsessed with cleaning the house and hosting parties. At times the client is overly joyous and has a very elevated sense of self-confidence. The adult child states that the client has also demonstrated very impulsive spending habits and expresses concern about the client giving away large sums of money to others. The client's speech is very pressured, disorganized, and loud. Client unable to recall the last time they ate.-
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"This medication can cause nausea and drowsiness."
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"Blurred vision is an expected adverse effect of this medication."
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"You will be placed on a low-sodium diet while taking this medication."
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"This medication can cause weight gain."
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"It will take at least a week before this medication reaches a therapeutic level."
Answer & explanation
Correct: "This medication can cause nausea and drowsiness." · "This medication can cause weight gain." · "It will take at least a week before this medication reaches a therapeutic level."
Nausea and drowsiness are common side effects of lithium and clients should be advised to take it with food. Weight gain is a well-documented side effect of lithium therapy. Lithium takes 1 to 2 weeks to reach therapeutic serum levels (0.6–1.2 mEq/L for maintenance); clients need education about this delay. Blurred vision is a sign of lithium toxicity, not an expected/routine adverse effect to normalize. A low-sodium diet is contraindicated with lithium — sodium depletion increases lithium reabsorption and can cause toxicity; clients should maintain a consistent, adequate sodium and fluid intake. (ATI Pharmacology: Mood-Stabilizing Medications; Karch, Focus on Nursing Pharmacology.)
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