Question

the nurse on a mental health unit is caring for a client with bipolar disorder who is prescribed lithium 600 mg for an acute episode of mania. the client has responded well to therapy but reports some mild nausea. in reviewing laboratory data, the nurse notes that the clients lithium level is 1.5 meq/l (1.5 mmol/l). what action should the nurse take first?

request a prescription for antinausea medication.
reassure the client that the therapy is progressing well.
hold the next dose of lithium.
administer the dose of lithium as prescribed.

Explanation:

The therapeutic range for lithium in acute mania is typically 1.0-1.5 mEq/L (1.0-1.5 mmol/L). The client's level is at the upper end of the therapeutic range, and mild nausea is a common, mild side effect. There is no indication of toxicity (levels >1.5 mEq/L for acute treatment), so the dose should be given as prescribed. Antinausea medication may be considered later if nausea persists, but it is not the first action. Reassurance is not the priority clinical action, and holding the dose is unnecessary as the level is therapeutic.

Answer:

D. Administer the dose of lithium as prescribed.