A patient with bipolar disorder is admitted to the hospital. The patient has been taking lithium [Lithobid] for several years and has not been evaluated by a provider for over a year
Besides obtaining a lithium level, the nurse caring for this patient will anticipate orders for which labora-tory tests? (Select all that apply.) a. Calcium level
b. Complete blood count with differential
c. Liver function tests
d. Renal function tests
e. Serum potassium
f. Thyroid function tests
B, D, F
Patients taking lithium can develop a mild, reversible leukocytosis, so annual CBC evaluation with differential is recommended. Chronic lithium use is associated with degenerative changes in the kidneys, so renal function should be assessed annually. Lithium can reduce the incorporation of iodine into thyroid hormone and can inhibit thyroid secretion; therefore, thyroid hormone and thyroid-stimulating hormone (TSH) levels should be measured annually. Lithium is affected by sodium levels but not by calcium or potassium levels. Because lithium is excreted by the kidneys, hepatic function tests are not indicated.
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A nurse practitioner is reviewing the prepregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy?
A) Hepatic metabolism of drugs that are normally metabolized by the kidneys B) Increased drug distribution resulting from hemodynamic changes C) Decreased absorption of inhaled drugs due to decreased tidal volume D) Decreased excretion rates as a result of decreased glomerular filtration rate during pregnancy
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a. Administer the original drug, and observe the client frequently for adverse reactions to the first drug. b. Call the health care provider immediately, and complete an incident report. c. Check the client's MAR for drug allergies, and if there is no indicated allergy to the drug administered in error, no further action is necessary. d. Document the error on the client's medical record, and notify the supervisor.
A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says,
"Someone else was using the copier, so I couldn't finish it." The worker's behavior demonstrates: a. acting out. b. projection. c. rationalization. d. passive aggression.
A patient with PAD is scheduled to have percutaneous transluminal angioplasty (PTA). What information does the nurse give the patient about this procedure?
a. It is usually used when amputation is inevitable. b. Reocclusion may occur afterwards and the procedure may be repeated. c. Most patients are occlusion-free afterwards, particularly if stents are placed. d. It is painless and there are very few risks or dangers.