Sam, a bipolar client, is prescribed lithium to stabilize his ...

[madam-professor]

Sam, a bipolar client, is prescribed lithium to stabilize his mood. He comes into the mental health clinic to have his blood levels tested, and the level is 1.8 mEq/L. What symptoms would the nurse expect to see in this client?
 
  A) None, this is a therapeutic blood level
  B) Nausea, vomiting, and muscle weakness
  C) ECG changes, coarse hand tremors, and mental confusion
  D) Severe hypotension, seizures, and ataxia

Question 2

The nurse is talking with Karen, a client admitted with bipolar who is having auditory hallucinations. Karen says, Do you hear those voices? They keep telling me that I should kill myself. Which of the following would be the nurse's best response?
 
  A) Why would the voices tell you to hurt yourself?
  B) Are the voices telling you anything else?
  C) I don't hear any voices, but you seem to be upset.
  D) There are no voices, are you sure you hear anything?

[diana chang]

Answer to Question 1

Ans: C
Feedback:
ECG changes, coarse hand tremors, and mental confusion are seen with lithium levels between 1.5 and 2.0 mEq/L. Nausea, vomiting, and muscle weakness would be seen with a level of 1.5 mEq/L. Severe hypotension, seizures, and ataxia are seen with lithium levels between 2.0 and 2.5 mEq/L.

Answer to Question 2

Ans: C
Feedback:
Nurses do not argue with clients about the validity of hallucinations. Instead, they inform clients that they do not share the misperception. Another helpful strategy is to focus on a client's feelings about the hallucination, not the content itself (You seem upset, not Why would the voices tell you to hurt yourself?). Nurses convey acceptance of and respect for clients while testing reality.

[madam-professor]

Thank you

[diana chang]

Happy to help you