The client has been prescribed lithium and takes this medication to treat bipolar disorder. The client has been trying to reduce sodium intake to help manage hypertension. Which of the following may occur as a result?
1. Increased urinary losses of lithium
2. Increased urinary losses of magnesium
3. Increased lithium reabsorption in the kidneys
4. Hypocalcemia
5. Increased risk of lithium toxicity
3, 5
Rationale: When clients use lithium and restrict their sodium intake, their kidneys reabsorb more lithium from the urine and this increases their risk of lithium toxicity. Increased fluid intake can increase urinary losses of lithium. Alcohol intake increases urinary losses of magnesium. Hypocalcemia is often the result of an endocrine disorder but also can occur as a result of using loop diuretics. Hypocalcemia, urinary losses of magnesium, and urinary losses of lithium are not associated with sodium restrictions.
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