A nurse is caring for a client prescribed Lithium. Which nur… | MyMerci
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Medication AdministrationPPT
Question
A nurse is caring for a client prescribed Lithium. Which nursing action is most appropriate regarding monitoring serum lithium levels and maintaining adequate fluid and sodium intake?
1Allergic reaction to TPN — discontinue TPN, administer antihistamines and corticosteroids, and provide supportive care while switching to enteral feeding.
2Fluid volume overload — restrict sodium and water intake, administer loop diuretics such as furosemide, and hold TPN until respiratory status improves and electrolyte levels stabilize.
3Refeeding syndrome — reduce caloric load, aggressively replace phosphate/magnesium/potassium, supplement thiamine before resuming, advance nutrition slowly under close monitoring
4Electrolyte imbalance from inadequate replacement — increase potassium, magnesium, and phosphate supplements, continue TPN at current rate, and monitor labs in 24 hours.✓ Correct answer
Explanation
When administering Lithium, key nursing considerations include monitoring patient status, checking critical laboratory values, and providing appropriate safety education. Unsafe practices such as stopping medications abruptly or doubling missed doses are incorrect.
Memory Tip Refeeding = "Phosphate-Magnesium-Potassium DROP + Thiamine BEFORE carbs." Identify high risk: BMI 15%, no intake >10 days, low pre-feeding electrolytes.
Clinical scenario
Scenario 65-year-old female with severe protein-calorie malnutrition started on TPN. 48 hr later: dyspnea, confusion, weakness, phosphate 1.2, Mg 1.3, K 3.0.