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A resident of a long-term care facility is taking lithium carbonate to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers?

Question

A resident of a long-term care facility is taking lithium carbonate to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers?

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Solution

  1. Monitor the resident's lithium levels: Lithium has a narrow therapeutic index, meaning there's a small range between a therapeutic dose and a toxic dose. Regular blood tests are necessary to ensure the resident's lithium levels are within the therapeutic range.

  2. Watch for signs of lithium toxicity: These can include diarrhea, vomiting, drowsiness, muscular weakness, and lack of coordination. If these symptoms occur, contact a healthcare professional immediately.

  3. Ensure the resident stays hydrated: Lithium is processed by the kidneys and can be dehydrating. Make sure the resident drinks plenty of fluids, especially if they are sweating more than usual or have a fever.

  4. Maintain a consistent sodium intake: Lithium levels can be affected by the amount of sodium in the body. Sudden changes in sodium intake can affect lithium levels, so try to keep the resident's sodium intake consistent.

  5. Regularly monitor the resident's kidney and thyroid function: Long-term use of lithium can affect these organs, so regular check-ups are necessary.

  6. Encourage the resident to avoid alcohol: Alcohol can increase the risk of lithium toxicity and can also exacerbate the symptoms of bipolar disorder.

  7. Remind the resident to take the medication regularly: Skipping doses can lead to a relapse of bipolar symptoms.

  8. Report any changes in behavior: If the resident shows new or worsening symptoms of depression, suicidal thoughts, or unusual behavior, these should be reported to a healthcare professional immediately.

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