NURS 211 Quiz 4| 2026 Latest Update with Complete
Solution-West Coast University
MEDICATION: Lithium
o #1 medication given to patient with BIPOLAR DISORDER.
o it is a MOOD STABILIZER
o When patient LITHIUM level is LOW, and it is time to administer Lithium what do you
do?
▪ administer medication
▪ assess patient
▪ notify provider that you administer medication, the patient’s level of lithium is
low.
▪ wait for orders from provider.
o When patient’s SODIUM level is LOW, do you administer Lithium?
▪ NO, because when the sodium level it is not within range, it can cause Lithium
TOXICITY.
o When patient’s LITHIUM level is HIGH, what do you do?
▪ stop medication administration IMMEDIATELY
▪ notify provider
Lithium Toxicity what type of labs are needed
o BUN (10-20 mg/dL)
o Creatinine (male: 0.6-1.2 mg/dL, female: 0.5-1.1 mg/dL)
o Sodium (135-145 mEq/L)
o Lithium Level (0.6-1.2 mEq/L)
▪ take medication with meals and milk to AVOID gastric irritability
▪ Interactions
• diuretics
o due to sodium excretion from diuretic and lithium excretion can
lead to toxicity
• NSAIDS
o due to renal reabsorptions with lithium that can increase the
risk of toxicity
o only use ASPIRIN
• Antihistamine
o avoid meds that causes anticholinergic effects
• Tricyclic antidepressants
o avoid meds that causes anticholinergic effects
▪ Complications
• Nausea
• diarrhea
• abdominal pain
• fine hand tremor
• POLYURIA (excessive urination)
o use K-sparing diuretic
▪ SPIRONOLACTONE
, • RENAL TOXICITY
o monitor for
▪ BUN
▪ Creatinine
• GOITER/HYPOThyroidism
o with long term use
▪ TSH levels
• T3
• T4
▪ brady dysrhythmias
▪ hypotension
▪ electrolyte imbalance
• maintain adequate SODIUM + FLUID intake
▪ Levels of Toxicity
• 1.2-1.5
o common adverse effect
▪ diarrhea
▪ nausea
▪ vomiting
▪ polyuria
▪ muscle weakness
▪ slurred speech
▪ lethargy
o Nurse interaction
▪ instruct the patient that the manifestation will improve
overtime
• 1.5-2.0
o early adverse effect
▪ confusion
▪ sedation
▪ poor coordination
▪ coarse tremor
▪ nausea
▪ vomiting
▪ diarrhea
o Nurse interaction
▪ hold medication and notify provider ASAP
▪ VOID is promoted
▪ administration of medication based on BLOOD LITHIUM
LEVEL.
• 2.0-2.5
o Advance toxicity adverse effects
▪ extreme polyuria
▪ tinnitus
Solution-West Coast University
MEDICATION: Lithium
o #1 medication given to patient with BIPOLAR DISORDER.
o it is a MOOD STABILIZER
o When patient LITHIUM level is LOW, and it is time to administer Lithium what do you
do?
▪ administer medication
▪ assess patient
▪ notify provider that you administer medication, the patient’s level of lithium is
low.
▪ wait for orders from provider.
o When patient’s SODIUM level is LOW, do you administer Lithium?
▪ NO, because when the sodium level it is not within range, it can cause Lithium
TOXICITY.
o When patient’s LITHIUM level is HIGH, what do you do?
▪ stop medication administration IMMEDIATELY
▪ notify provider
Lithium Toxicity what type of labs are needed
o BUN (10-20 mg/dL)
o Creatinine (male: 0.6-1.2 mg/dL, female: 0.5-1.1 mg/dL)
o Sodium (135-145 mEq/L)
o Lithium Level (0.6-1.2 mEq/L)
▪ take medication with meals and milk to AVOID gastric irritability
▪ Interactions
• diuretics
o due to sodium excretion from diuretic and lithium excretion can
lead to toxicity
• NSAIDS
o due to renal reabsorptions with lithium that can increase the
risk of toxicity
o only use ASPIRIN
• Antihistamine
o avoid meds that causes anticholinergic effects
• Tricyclic antidepressants
o avoid meds that causes anticholinergic effects
▪ Complications
• Nausea
• diarrhea
• abdominal pain
• fine hand tremor
• POLYURIA (excessive urination)
o use K-sparing diuretic
▪ SPIRONOLACTONE
, • RENAL TOXICITY
o monitor for
▪ BUN
▪ Creatinine
• GOITER/HYPOThyroidism
o with long term use
▪ TSH levels
• T3
• T4
▪ brady dysrhythmias
▪ hypotension
▪ electrolyte imbalance
• maintain adequate SODIUM + FLUID intake
▪ Levels of Toxicity
• 1.2-1.5
o common adverse effect
▪ diarrhea
▪ nausea
▪ vomiting
▪ polyuria
▪ muscle weakness
▪ slurred speech
▪ lethargy
o Nurse interaction
▪ instruct the patient that the manifestation will improve
overtime
• 1.5-2.0
o early adverse effect
▪ confusion
▪ sedation
▪ poor coordination
▪ coarse tremor
▪ nausea
▪ vomiting
▪ diarrhea
o Nurse interaction
▪ hold medication and notify provider ASAP
▪ VOID is promoted
▪ administration of medication based on BLOOD LITHIUM
LEVEL.
• 2.0-2.5
o Advance toxicity adverse effects
▪ extreme polyuria
▪ tinnitus
