Which instruction(s) is/are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged? (Select all that apply.)
a. "Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately."
b. "It is important to comply with schedules for blood tests to assess therapeutic levels."
c. "You should avoid foods such as Chianti wine and aged cheeses."
d. "The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve."
e. "You will be gradually weaned off this medication."
f. "Take the medication with food or milk."
ANS: A, B, D, F
Patients should be informed of the importance of toxic symptoms to report and monitoring therapeutic lithium levels. Nausea, vomiting, and abdominal cramps are common adverse effects and tend to resolve. Lithium should be administered with food or milk. Chianti wine and aged cheeses are to be avoided during MAOI therapy. The bipolar patient may be on lithium treatment for the rest of his or her life and will not be weaned from the medication.
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