A client in the manic phase of bipolar disorder is prescribed lithium and has a current level of 0.4. Which clinical manifestation does the nurse anticipate when assessing this client?
A) A decrease in manic behavior.
B) Hyperactivity and pressured speech.
C) A return to baseline behavior, calm and rational.
D) Signs and symptoms of depression.
Answer: B
A therapeutic lithium level is 1.0-1.5 mEq/L. Because this client's level is low, behaviors will indicate mania, that is, hyperactivity and pressured speech. There will be no decrease in manic behavior because the lithium level is too low. The client will not exhibit signs and symptoms of depression, but will continue in the manic phase until the lithium level is within a therapeutic range. The client will not return to baseline behavior, but will continue in the manic phase until the lithium level is within a therapeutic range.
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