Which statement by a client who will be maintained on lithium following discharge should the nurse evaluate as evidence of a need for further instruction?
1. "I will not take my morning lithium until after I have my blood work done."
2. "When I get home, I may go on a salt-free diet."
3. "I have learned not to restrict my intake of water."
4. "I understand some people gain weight on lithium."
ANS: 2
This statement shows that the client does not understand the relationship between lithium and sodium. The client must be taught that changing dietary salt intake will affect lithium levels. Adding salt can cause lower levels; reducing salt can result in toxicity. 1. This is appropriate. Se-rum levels are drawn 12 hours after the last dose of lithium. 3. This is appropriate. Water re-striction can result in adverse effects. 4. Weight gain is a concern for some clients.
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