A patient recently was diagnosed with bipolar disorder. The patient, who has a history of seasonal allergies, is an athlete who participates in track. The nurse is teaching the patient about lithium [Lithobid], which the prescriber has just ordered
Which statement by the patient indi-cates the need for further teaching? a. "I can continue to use ibuprofen as needed for muscle pain."
b. "I should drink extra fluids before and during exercise."
c. "I should not use antihistamines while taking lithium."
d. "I should report muscle weakness and tremors to my provider."
A
Because nonsteroidal anti-inflammatory drugs (NSAIDs) can increase lithium levels as much as 60%, they should not be used by patients taking lithium. Aspirin does not have this effect. Li-thium induces polyuria in 50% to 70% of patients, so patients should be advised to drink extra fluids, especially during exercise. Antihistamines have anticholinergic effects, which cause uri-nary hesitancy; this can be uncomfortable when patients experience the polyuria associated with lithium use. Muscle weakness and tremors can occur with lithium; tremors can be treated with beta blockers or by altering the lithium regimen.
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