A patient with bipolar disorder and who takes lithium telephones the nurse at the clinic to say, "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?"
The nurse should advise the patient:
a. "Restrict food and fluids for 24 hours, and stay in bed."
b. "Have someone bring you to the clinic immediately."
c. "Drink a large glass of water with 1 teaspoon of salt added."
d. "Take an over-the-counter antidiarrheal medication hourly until the diarrhea subsides."
ANS: B
The symptoms described suggest lithium toxicity. The patient should have a lithium level drawn and may require further treatment. Because neurologic symptoms are present, the patient should not drive and should be accompanied by another person. The incorrect options will not ameliorate the patient's symptoms.
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