A patient is being treated for bipolar disorder with lithium carbonate (Eskalith). He also suffers from congestive heart failure and hypertension. The patient has an increased fluid volume and has recently had difficulty breathing
What laboratory value will most affect the action of the patient's lithium carbonate? A) Increased hematocrit
B) Increased sodium level
C) Increased potassium level
D) Increased white blood cell count
B
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A sodium excess causes more lithium to be excreted and may lower lithium levels to nontherapeutic ranges. An increased lithium level would not be noted with a patient who has fluid volume excess and hypertension. An increased potassium level is unlikely with fluid volume excess. An increased white blood cell count is indicative of infection, from which the patient does not suffer.
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