A client with bipolar disorder has been taking lithium carbo… | MyMerci
Medical EmergenciesPA
Question
A client with bipolar disorder has been taking lithium carbonate for 2 weeks. The nurse reviews a trough lithium level drawn 12 hours after the last dose: 0.8 mEq/L. Which action is most appropriate?
1Hold the lithium and prepare for hemodialysis because the level is toxic.
2Give sodium polystyrene sulfonate to lower the lithium level.
3Administer an extra dose because the level is subtherapeutic for acute mania.
4Continue the prescribed dose and reinforce that the level is within the usual therapeutic range.✓ Correct answer
Explanation
A 12-hour trough lithium level of 0.6-1.2 mEq/L is generally therapeutic for maintenance therapy. Toxicity risk rises as levels approach 1.5 mEq/L and above, especially with dehydration or renal impairment. The nurse should continue the current plan and reinforce scheduled monitoring rather than holding or increasing the dose.
In-depth explanation
Memory Tip Lithium is a narrow-therapeutic-index drug: check a 12-hour trough, monitor renal/thyroid function, and teach hydration and consistent sodium intake.