Which of the following instructions regarding lithium therapy should be included in a nurse's discharge teaching? (Select all that apply.)
1. Avoid excessive use of beverages containing caffeine.
2. Maintain a consistent sodium intake.
3. Consume at least 2,500 to 3,000 mL of fluid per day.
4. Restrict sodium content.
5. Restrict fluids to 1,500 mL per day.
1, 2, 3
Rationale: The nurse should instruct the client taking lithium to avoid excessive use of caffeine, maintain a consistent sodium intake, and consume at least 2,500 to 3,000 mL of fluid per day. The risk of developing lithium toxicity is high because of the narrow margin between therapeutic doses and toxic levels. Fluid or sodium restriction can impact lithium levels.
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