A patient with bipolar disorder was hospitalized 5 days ago and has received lithium 600 mg TID. The staff now observes agitation, pressured speech, poor personal hygiene, hyperactivity, and bizarre clothing. Select the nurse's best action
a. Consider the need to measure the serum lithium level. The patient may not be swallowing the medication.
b. Include the patient in psychoeducational groups about personal hygiene, dressing, and grooming.
c. Ask the health care provider to prescribe an increased dose and frequency of lithium.
d. Continue to monitor and document the patient's speech patterns and motor activity.
A
The patient is continuing to exhibit manic symptoms. The lithium level may be low from "cheeking" medication. The prescribed dose is high, so one would not expect the dose to be increased.
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