A nurse is planning to teach a client who is taking lithium. Which of the following should the nurse include in the teaching as adverse effects of therapeutic lithium level?
A.
Weight gain and dry mouth
B.
Oliguria and muscle weakness
C.
Hallucinations and blurred vision
D.
Coarse hand tremors and confusion
The Correct Answer and Explanation is:
The correct answer is D. Coarse hand tremors and confusion.
Explanation:
Lithium is a medication commonly used to treat bipolar disorder. When administered within the therapeutic range, it can effectively stabilize mood, but it also has potential adverse effects that need to be monitored closely. Understanding these effects is crucial for patient safety and effective treatment management.
Coarse hand tremors and confusion are key adverse effects associated with therapeutic levels of lithium. Coarse hand tremors are often one of the earliest signs of lithium toxicity or an indication that lithium levels are approaching the upper limit of the therapeutic range. These tremors can be uncomfortable and may interfere with daily activities, but they generally occur when lithium levels are higher than the ideal therapeutic range.
Confusion or cognitive disturbances are also significant adverse effects. Although confusion may not always occur at therapeutic levels, it can be indicative of lithium toxicity, particularly if the levels exceed the therapeutic range. Both symptoms together suggest that lithium levels might need adjustment or closer monitoring.
Here’s a brief overview of why the other options are less relevant:
- A. Weight gain and dry mouth: These are not typically seen as immediate adverse effects of therapeutic lithium levels. While weight gain can occur with long-term use of lithium, and dry mouth may be a minor issue, they are not characteristic of acute adverse effects related to lithium levels.
- B. Oliguria and muscle weakness: Oliguria (reduced urine output) and muscle weakness are more indicative of lithium toxicity, especially in cases of severe toxicity. These symptoms are not usually associated with therapeutic levels but rather higher or toxic levels.
- C. Hallucinations and blurred vision: These symptoms are more severe and suggest a level of toxicity rather than just therapeutic levels. They are not common at therapeutic levels and usually indicate significant lithium overdose.
Monitoring lithium levels and recognizing signs of toxicity are critical aspects of managing treatment. Regular blood tests to check lithium levels, along with vigilant observation for symptoms like tremors and confusion, are essential for ensuring the medication’s effectiveness while minimizing adverse effects.