The patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The patient's current lithium level is 0.4. What will the nurse expect to assess in this patient?
1. A return to baseline behavior, calm and rational
2. Hyperactivity and pressured speech
3. Signs and symptoms of depression
4. A decrease in manic behavior
2
Rationale 1: The patient will not return to baseline behavior but will continue in the manic phase until the lithium level is within a therapeutic range.
Rationale 2: A therapeutic lithium level is 0.6 to 1.5. Since this patient's level is low, behaviors will indicate mania (i.e., hyperactivity and pressured speech).
Rationale 3: The patient 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 patient will not return to baseline behavior but will continue in the manic phase until the lithium level is within a therapeutic range.
Rationale 4: There will be no decrease in manic behavior because the lithium level is not within range.
Global Rationale: A therapeutic lithium level is 0.6 to 1.5. Since this patient's level is low, behaviors will indicate mania (i.e., hyperactivity and pressured speech). There will be no decrease in manic behavior because the lithium level is too low. The patient 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 patient 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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