An outpatient diagnosed with bipolar disorder is prescribed lithium. The patient telephones the nurse to say, "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?"
The nurse will advise the patient to:
a. restrict food and fluids for 24 hours and stay in bed.
b. have someone bring the patient to the clinic immediately.
c. drink a large glass of water with 1 teaspoon of salt added.
d. take one dose of an over-the-counter antidiarrheal medication now.
ANS: B
The symptoms described suggest lithium toxicity. The patient should have a lithium level drawn and may require further treatment. Because neurological symptoms are present, the patient should not drive and should be accompanied by another person. The incorrect options will not ameliorate the patient's symptoms.
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