Author Question: A nurse assesses the patient for possible lithium toxicity when the serum lithium level reaches 2.5 ... (Read 94 times)

crazycityslicker · **on:** Jul 23, 2018

A nurse assesses the patient for possible lithium toxicity when the serum lithium level reaches 2.5 mEq/L. Which clinical manifestations would the nurse anticipate with lithium toxicity? (Select all that apply.)

a. Hyperactivity
b. Slurred speech
c. Constipation
d. Muscle twitching
e. Ataxia
f. Hypertension

Question 2

A patient with a history of bipolar disorder has been on lithium therapy for 3 years. The patient begins to develop hypertension. Which class of drugs, if given concurrently with lithium, would result in an adverse drug-to-drug interaction?

a. ACE inhibitors
b. Vasodilators
c. Diuretics
d. Calcium channel blockers

pocatato · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B, D, E
A patient with lithium toxicity is hyponatremic, which may be manifested by slurred speech, muscle twitching, and mild to moderate ataxia.
Hyperactivity, constipation, and hypertension are not manifestations associated with lithium toxicity.

Answer to Question 2

ANS: C
Diuretics promote sodium loss and thereby can increase the risk of lithium toxicity. Toxicity occurs because in the presence of low sodium, renal excretion of lithium is reduced, which causes lithium levels to rise.
There are no adverse drug-to-drug interactions between lithium and ACE inhibitors, vasodilators, and calcium channel blockers, therefore any of them can be given to treat the patient's hypertension.