A patient with bipolar disorder reveals to the clinic nurse that she may be 4 weeks' preg-nant. Which action will the nurse take?
a. Confer with the physician about ordering a pregnancy test and discontinuing lith-ium.
b. Educate the patient to the risk to the fetus as a result of exposure to the lithium in her blood.
c. Suggest to the physician that the lithium dose should be increased for better symptom control.
d. Remind the patient that barrier birth control methods should be used to prevent pregnancy during lithium therapy.
ANS: A
The first need is to learn whether the patient is pregnant. Lithium ingestion by the mother can cause fetal damage. Lithium should be discontinued, not increased, if pregnancy is con-firmed. It is premature to discuss fetal malformations before the pregnancy is confirmed. Op-tions b and c are inappropriate and harmful. Birth control information has no value unless the pregnancy test is negative.
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