A nurse is preparing to administer medications to a hospitalized patient who has been taking lithium (Lithobid) for 3 days. The patient is complaining of mild nausea and abdominal bloating
The patient's lithium level is 0.8 mEq/L. What will the nurse do?
a. Administer the dose and tell the patient that the side effects are temporary.
b. Contact the prescriber to request an order for serum electrolytes.
c. Hold the dose and notify the prescriber of the patient's lithium level.
d. Request an order for amiloride (Midamor).
ANS: A
This patient is experiencing side effects that are common and that occur at therapeutic levels of the drug. The lithium level is therapeutic and not toxic, so the nurse should give the dose and reassure the patient that the side effects will diminish over time. In the presence of low sodium, lithium can accumulate to toxic doses; therefore, if the lithium level were elevated, evaluating serum electrolytes would be advisable. The dose does not need to be withheld, because the patient does not have toxic levels of lithium. Amiloride is used if patients are experiencing lithium-induced polyuria, which this patient does not have.
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