PSYCHIATRIC NURSING QUESTIONS AND ANSWERS 2
lithium
1st line treatment for mood stabilization
therapeutic index- 0.8-1.4 mEq/L
maintenance level- 0.4-1.3 mEq/L
toxic level- 1.5 and above mEq/L
onset takes 10-21 days
lithium
less than 1.5 mEq/L side effects
expected sings
Nausea
vomiting
diarrhea
thirst, polyuria (producing too much urine)
lethargy
sedation
fine hand tremor
Renal toxicity may occur with long-term use
Goiter and hypothyroidism
interventions
Symptoms often subside during treatment
Doses should be kept low
Kidney function and thyroid levels should be assessed before treatment and then on an annual
basis
lithium
1.5-2 mEq/L side effects
early signs of toxicity
Gastrointestinal upset
coarse hand tremor
confusion
hyperirritability of muscles
, electroencephalographic changes
sedation
incoordination
interventions
Medication should be withheld
blood lithium levels measured
dosage reevaluated
lithium
2.0-2.5 mEq/L side effects
advanced signs of toxicity
Ataxia
giddiness
serious electroencephalographic changes
blurred vision
clonic movements
large output of dilute urine
seizures
stupor
severe hypotension
coma
Death is usually secondary to pulmonary complications
interventions
Hospitalization is indicated
The drug is stopped, and excretion is hastened. Whole bowel irrigation may be done to prevent
further absorption of lithium
lithium
greater than 2.5 side effects
severe toxicity
Convulsions
oliguria (producing none or small amounts of urine)
death can occur
interventions
hemodialysis may be used in severe cases
lithium
1st line treatment for mood stabilization
therapeutic index- 0.8-1.4 mEq/L
maintenance level- 0.4-1.3 mEq/L
toxic level- 1.5 and above mEq/L
onset takes 10-21 days
lithium
less than 1.5 mEq/L side effects
expected sings
Nausea
vomiting
diarrhea
thirst, polyuria (producing too much urine)
lethargy
sedation
fine hand tremor
Renal toxicity may occur with long-term use
Goiter and hypothyroidism
interventions
Symptoms often subside during treatment
Doses should be kept low
Kidney function and thyroid levels should be assessed before treatment and then on an annual
basis
lithium
1.5-2 mEq/L side effects
early signs of toxicity
Gastrointestinal upset
coarse hand tremor
confusion
hyperirritability of muscles
, electroencephalographic changes
sedation
incoordination
interventions
Medication should be withheld
blood lithium levels measured
dosage reevaluated
lithium
2.0-2.5 mEq/L side effects
advanced signs of toxicity
Ataxia
giddiness
serious electroencephalographic changes
blurred vision
clonic movements
large output of dilute urine
seizures
stupor
severe hypotension
coma
Death is usually secondary to pulmonary complications
interventions
Hospitalization is indicated
The drug is stopped, and excretion is hastened. Whole bowel irrigation may be done to prevent
further absorption of lithium
lithium
greater than 2.5 side effects
severe toxicity
Convulsions
oliguria (producing none or small amounts of urine)
death can occur
interventions
hemodialysis may be used in severe cases
