# A client taking lithium reports vomiting and diarrhea for 2 days. Which instruction should the nurse give?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397252&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

A client taking lithium reports vomiting and diarrhea for 2 days. Which instruction should the nurse give?

## Option

1. Double the next dose if a dose was missed.
2. Limit fluids until the diarrhea stops.
3. Continue lithium because gastrointestinal illness does not affect levels.
4. Contact the provider because dehydration can increase lithium toxicity risk. **✔ Correct answer**

**Correct answer: 4**

## Explanation

Fluid and sodium loss from vomiting and diarrhea can increase lithium levels and toxicity risk. The client should contact the provider for guidance and possible level assessment. Doubling the dose or restricting fluids can worsen toxicity.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Lithium and dehydration.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Lithium and dehydration, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Lithium** — A mood stabilizer with a narrow therapeutic range.
- **Toxicity** — Harmful effects from excessive drug level or sensitivity.
- **Dehydration** — A fluid deficit that can alter medication concentration and perfusion.

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