A nurse is reviewing a patient's laboratory findings prior to medication administration. The most recent serum lithium level is 2.2 mEq/L and was drawn yesterday
The patient takes 300 mg of lithium carbonate 4 times a day. Which of the following is the nurse's most appropriate action?
a. Administer the drug as prescribed.
b. Recognize that the dose is subtherapeutic.
c. Administer half of the dose.
d. Hold the next dose and notify the prescriber.
ANS: D
The lithium level is toxic, therefore the dose should be held and the prescriber notified.
The drug should not be administered as prescribed, because it will increase the toxicity.
The dose is not subtherapeutic; rather, the patient's lithium level indicates toxicity.
It is up to the prescriber to change the dosage ordered. Changing the dosage without discussing it with the prescriber is a violation of the Nurse Practice Act, because nurses do not prescribe.
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