A patient who takes lithium phones the nurse at the clinic to ...

[Charlie]

A patient who takes lithium phones the nurse at the clinic to say, I've had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do? Which instruction by the nurse is appropriate?
 
  a. Have someone bring you to the clinic immediately..
  b. Restrict food and fluids for 24 hours and stay in bed..
  c. Drink a large glass of water with 1 teaspoon of salt added..
  d. Take antidiarrheal medication hourly until the diarrhea subsides..

Question 2

A Hispanic patient whose only child died over a year ago says, I cannot do my usual home duties or go out in my community because of my headaches and backaches. The patient is diagnosed with major depression.
 
  The staff nurse says in the team meeting, I can't help her. All she talks about is pain in her body. Which feedback from the team will be most helpful to this nurse? a. You should take the lead and focus on reasons for her resistance to therapy.
  b. In her culture, physical symptoms are expressions of distress and emotional pain.
  c. Ask the patient why she has chosen to grieve her child's death in this particular way.
  d. It will take the antidepressant medication about 3 weeks to reach therapeutic levels. Be patient.

[wfdfwc23]

Answer to Question 1

A
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.

Answer to Question 2

B
Somatization is common in this culture and demonstrates the patient's psychological pain. The distracters do not give the nurse helpful guidance.

[Charlie]

Excellent

[isabelt_18]

TYSM