A client is to receive lithium therapy as part of the treatment plan for bipolar disorder. When reviewing the client's medication history, which agents would alert the nurse to the possibility that a decrease in the lithium dosage may be needed? Select al

A) Lisinopril
B) Hydrochlorothiazide
C) Indomethacin
D) Caffeine
E) Aspirin


Ans: A, B, C
Drugs such as lisinopril, hydrochlorothiazide, and indomethacin increase serum lithium concentrations and as such might necessitate a reduction of the lithium dosage. Caffeine increases lithium excretion, so the drug dosage may need to be increased. Aspirin, unlike other nonsteroidal anti-inflammatory drugs, does not decrease renal clearance of lithium or increase serum lithium concentrations.

Nursing

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A) "The infiltration is causing you pain and you will be very relieved when I remove the IV line." B) "You should relax and take deep breaths; the procedure is very minor and will be over soon." C) "I know that you are anxious, but removal will be painless and the IV location needs to be changed." D) "It will be a painless procedure and there is nothing to worry about; many clients do fine with this."

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A nurse caring for a patient with Paget's disease is analyzing the patient's laboratory values. Which of the following values is most often seen in a patient with Paget's disease?

A) An elevated serum alkaline phosphatase level and elevated serum calcium levels B) A low serum alkaline phosphatase level and a low serum calcium level C) An elevated serum alkaline phosphatase level and a normal serum calcium level D) A normal serum alkaline phosphatase level and a low serum calcium level

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A 6-year-old boy with cerebral palsy has been admitted to the hospital for tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. How should the nurse respond?

A) "Would you like me to bring you a blanket and pillow?" B) "You are doing such a wonderful job with your son." C) "He's in good hands; consider going home and getting some sleep." D) "Are you planning to spend the night or to go home?"

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