A patient's serum lithium level is reported as 1.9 mEq/L. The nurse should immediately:
a. Restrict sodium and fluid intake.
b. Assess for signs and symptoms of toxicity.
c. Seek to have the patient transferred to ICU.
d. Notify the patient's physician immediately.
ANS: B
A serum lithium level this high suggests that the patient may be experiencing symptoms of lithium toxicity. Clinical assessment is essential to determine what, if any, signs and symp-toms are present. After the clinical assessment has been made, the nurse can provide the phy-sician with a complete picture. Restricting sodium and fluids would raise the serum level. Transferring may not be necessary and would require a physician's order.
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