# Which statement by a client taking lithium indicates that discharge teaching was effective?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375326&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

Which statement by a client taking lithium indicates that discharge teaching was effective?

## Option

1. If I forget a dose, I will take two doses at the next scheduled time to keep my lithium level steady.
2. I should drink no more than a few sips of water each day so the lithium is not washed out of my body.
3. I should keep my salt intake consistent and call the clinic if I have vomiting, diarrhea, fever, or heavy sweating. **✔ Correct answer**
4. I can safely use over-the-counter ibuprofen for pain relief because it does not affect my lithium level.

**Correct answer: 3**

## Explanation

Lithium teaching emphasizes consistent sodium and fluid intake, toxicity precautions during dehydration, and avoiding interacting drugs unless approved. Vomiting, diarrhea, fever, heavy sweating, low sodium intake, NSAIDs, ACE inhibitors, ARBs, and thiazide diuretics can increase lithium toxicity risk.

## In-depth explanation

Memory Tip Lithium follows salt and water: stable sodium + stable fluids = safer levels. Illness with fluid loss is a call-the-clinic event.

## Clinical scenario

Scenario Discharge education for lithium.

## Key concepts

- **Sodium consistency** — Low sodium intake or sodium loss increases renal lithium reabsorption and can raise serum lithium.
- **Sick-day teaching** — Vomiting, diarrhea, fever, or heavy sweating can cause dehydration and toxicity; call before continuing doses.
- **Missed dose safety** — Do not double lithium doses. Follow the prescribed missed-dose instructions or contact the clinic.

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