The nurse has been doing medication education for the client receiving lithium (Eskalith). Which statement by the client indicates that teaching has been effective?
1. "I need to call my physician if I excessively sweat during exercise."
2. "I need to restrict my intake of salt while I am taking lithium."
3. "I don't need to have my blood checked anymore after I leave the hospital."
4. "I can stop taking my lithium when my moods are stable."
1
Rationale 1:Excessive sweating can have a dehydrating effect on the body, leading to lithium toxicity.
Rationale 2:"I need to restrict my intake of salt while I am taking lithium" is incorrect because if a client does not have a regular intake of salt, the kidneys will stop excreting lithium, and lithium toxicity will result.
Rationale 3:"I don't need to have my blood checked anymore after I leave the hospital" is incorrect because routine serum lithium levels are required every 2–3 months that a client is receiving this drug.
Rationale 4:"I can stop taking my lithium when my moods are stable" is incorrect because bipolar disorder is a chronic illness; treatment with a mood stabilizer like lithium is necessary throughout a client's life.
Global Rationale: Lithium, a mood stabilizer, must remain constant in the blood to be in the effective range of 0.6–1.5mEq/L. Lithium is taken as a salt, so it mixes in the bloodstream like sodium chloride. Conditions in which sodium is lost, like excessive sweating or urination, can cause the kidneys to reabsorb the lithium salts back into the blood, producing elevated serum levels of lithium known as lithium toxicity.
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