Author Question: A patient diagnosed with bipolar disorder asks the nurse, Why can't I take my lithium just once a ... (Read 43 times)

awywial · **on:** Jul 19, 2018

A patient diagnosed with bipolar disorder asks the nurse, Why can't I take my lithium just once a day at bedtime? It's hard to remember to take it three times. The nurse's reply should be based on what information?

a. The half-life of lithium is short.
b. Renal excretion is greater at night.
c. GI absorption is diminished at night.
d. The toxicity potential increases with once-a-day dosing.

Question 2

A patient being treated at the mental health center says, I am having thoughts about suicide. Select the nurse's most therapeutic response.

a. Thank you for telling me, but there's nothing to worry about. We will handle it together.
b. Telling me about these feelings is a very positive action on your part.
c. It's important for you to be hospitalized as soon as possible.
d. Let's talk about the things you have to live for.

diana chang · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

A
Lithium has a short half-life, high toxicity, and rapid renal excretion, so multiple daily doses are required. The other statements are incorrect or are not factors considered in dosing.

Answer to Question 2

B
This response gives the patient reinforcement and validation for making a positive response rather than acting out a suicidal impulse. It gives neither advice nor false reassurance, and it does not imply stereotypes such as You have a lot to live for. It uses the patient's ambivalence and sets the stage for more realistic problem solving.