A patient who takes lithium phones the nurse at the clinic to say, "I've had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" Which instruction by the nurse is appropriate?
a. "Have someone bring you to the clinic immediately.".
b. "Restrict food and fluids for 24 hours and stay in bed.".
c. "Drink a large glass of water with 1 teaspoon of salt added.".
d. "Take antidiarrheal medication hourly until the diarrhea subsides.".
A
The symptoms described suggest lithium toxicity. The patient should have a lithium level drawn and may require further treatment. Because neurological symptoms are present, the patient should not drive and should be accompanied by another person.
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