A client in the manic phase of bipolar disorder is being provided with lithium and has a current level of 0.4. Which of the following will the nurse assess in this client?
1. A decrease in manic behavior
2. Signs and symptoms of depression
3. Hyperactivity and pressured speech
4. A return to baseline behavior, calm and rational
3. Hyperactivity and pressured speech
Rationale:
A therapeutic lithium level is 0.6 to 1.5. Since this client'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 client 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 client 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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