NR 302 HEALTH ASSESSMENT EXAM 3 WITH 100% SOLVED
SOLUTIONS
Lithium - interactions
-Diuretics: sodium is excreted with this; less excretion of lithium
... [Show More] leading to toxicity
-NSAIDS: increased renal absorption leading to toxicity
-antihistamines/tricyclic antidepressants: abdominal discomfort from urinary retention and
polyuria
-increased risk for toxicity
-more frequent monitoring of lithium levels - nursing considerations for older adults taking
Lithium?
2-3 weeks - Maximum benefits of Lithium may not be seen for
2-3 doses daily - Because of a short half-life, Lithium should be administered
-diarrhea
-vomiting
-excessive sweating - The client should withhold Lithium and seek medical attention for
experiencing
-slows entrance of sodium and calcium back into the neuron; takes longer for nerve to
return to normal state
-potentiating the inhibitory effects of GABA
-valproic acid
-carbamazepine
-lamotrigine
-oxcarbazepine
-topiramate - What are 4 antiepileptic medications used for bipolar disorder?
-antipsychotics
-anxiolytics
-antidepressants - What are 3 other classes of medications used for bipolar disorder?
-Lithium
-lithium - ____ replaces sodium - when sodium decreases, ___ increases
LITHIUM CARBONATE - ______ (for manic episodes)
-GI distress
-fine hand tremors
-polyuria, mild thirst
-weight gain
-renal toxicity
-goiter and hypothyroidism
-bradydysrhythmias, hypotension, electrolyte imbalance
-lithium toxicity - What are 7 complications of Lithium?
symptoms of early Lithium toxicity? -*lithium level: less than 1.5 mEq/L
-diarrhea
-nausea
-vomiting
-thirst
-polyuria
-muscle weakness
-fine hand tremor
-slurred speech
-lethargy
-mental confusion
-sedation
-poor coordination
-coarse tremors
-GI distress (N,V,D) - What assessment findings would you expect to see in a patient with a
Lithium level of 1.8
Rapid progression of manifestations leading to coma and death - What assessment findings
would you see in a patient with a Lithium level of 2.3?
-Category D (especially in first trimester)
-No brestfeeding
-Contraindicated in hepatic, renal, cardiac disease; hypovolemia; schizophrenia
-caution in older adults, thyroid disease, seizure disorder, diabetes -
contraindications/precautions of Lithium?
-Inhibits glutamate which suppresses CNS excitation - what 3 mechanisms do moodstabilizing antiepileptic drugs work?
-CNS effects
-blood dyscrasias
-teratogenisis
-hypoosmolarity
-skin disorders - 5 complications of Carbamazepine
steven johnsons syndrome - What syndrome is sometimes seen in patients taking
Lamotrigine?
Valproate - ADVERSE EFFECTS:
-GI effects
-hepatotoxicity
-pancreatitis
-thrombocytopenia
-teratogenesis
-weight gain
Carbamazepine? - INTERACTIONS [Show Less]