The client asks the nurse why she needs to continue using table salt, because her prescribed lithium (Eskalith) is a salt. What is the best response by the nurse?

Question

1. "You must continue to use salt to avoid lithium (Eskalith) toxicity. If you use sea salt, you don't need as much."
2. "You must use table salt or your kidneys will retain lithium (Eskalith), and you will become toxic."
3. "Salt is very important to avoid lithium (Eskalith) toxicity, but not as important as drinking 1 to 1.5 L of water per day."
4. "The amount is not important; just increase your table salt if you notice signs of lithium (Eskalith) toxicity."

Answer 1

Correct Answer: 2
Rationale 1: There is no evidence to support the claim that sea salt is more effective than any other kind of salt.
Rationale 2: The kidneys are responsible for maintaining normal sodium levels. If there is sodium depletion, the kidneys will conserve any salt—in this case, lithium (Eskalith). This will lead to lithium (Eskalith) toxicity.
Rationale 3: Drinking 1 to 1.5 L of water per day of water is important, but does not substitute for adequate sodium chloride intake.
Rationale 4: Instructing a client to increase salt if toxicity occurs is inappropriate because the client must try to avoid toxicity, not treat it after it occurs.
Global Rationale: The kidneys are responsible for maintaining normal sodium levels. If there is sodium depletion, the kidneys will conserve any salt—in this case, lithium (Eskalith). This will lead to lithium (Eskalith) toxicity. There is no evidence to support the claim that sea salt is more effective than any other kind of salt. Drinking 1 to 1.5 L of water per day of water is important, but does not substitute for adequate sodium chloride intake. Instructing a client to increase salt if toxicity occurs is inappropriate because the client must try to avoid toxicity, not treat it after it occurs.