Question

Richard is a 25 y.o. male patient who is being admitted to the inpatient mental health unit. He has a diagnosis of Bipolar 1 disorder. He has no history of physical or medical illnesses. During the admission assessment, Richard indicates that when he was 21 y.o., he was treated for bipolar 1 as an outpatient in the hospital clinic. He indicates was prescribed Carbamazepine but stopped taking it about 1 year ago. He told the nurse he has recently moved to the city as a mechanic, lives with a close relative temporarily. He does not have any friends in the city. About 3 weeks ago he had a surge of energy, was working 14-hour days and was up at night for days. During the interaction Richard often talked about his past depression and suicidality. Over the past month he has lost 15 lbs., has difficulty eating and has no appetite. He does not have the”…energy to get out of bed..” and has missed 4 days of work in the past week. He acknowledges having thoughts of ending his life by “driving off the road”. However, he says he is uncertain and afraid that if he takes his own life he will go to hell. You are the nurse assigned to provide care to Richard.

What would you include in your teaching to a patient about taking lithium?

Answer 1

Ans. Heath education should be provided to patient taking lithium.

A) Be alert about Increase in output of dilute urine and persistent thirst. Dose reduction can be indicated.

B) if patient has diarrhea or fever develops, contact physician.avoid things that may increase dehydrationas hot environment, excessive caffeine, beverage.

C)drink plenty of liquid(2-3/d). during stablization period and 1-1and half /day during ongoing therapy.

D)avoid self prescribed low salt regimen, self dosing with antacid containing sodium and high sodium(meat,diet soda).

E). Do not drive or do any potential hazardous activity until response to drug is known.

F) use effective contraceptives measure during lithium therapy. If therapy continued during pregnancy, serum lithium level should be monitored to prevent toxicity.

G) do not breast feed during therapy.

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