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 laboratory 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
ANS: 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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