Questions and Answers
What is the therapeutic drug serum level of lithium?
Lithium is classified as pregnancy category D.
True
List two common adverse effects of lithium.
Polyuria, polydipsia
What action should be taken if a missed dose of lithium is remembered?
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What should be monitored during lithium treatment?
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Symptoms of lithium toxicity begin to appear when the serum lithium level is __________.
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Match the levels of lithium toxicity with their symptoms:
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Excessive caffeine intake can affect lithium's effectiveness.
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What should be done immediately if lithium toxicity is suspected?
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Study Notes
Lithium Overview
- Concurrent use with diuretics and certain medications increases lithium reabsorption, raising the risk of toxicity.
- Therapeutic serum lithium level is 0.6 to 1.2 mEq/L; toxicity levels vary among individuals.
- Factors causing increased lithium levels include decreased sodium intake, dehydration, and diuretic therapy.
- Monitor serum lithium levels frequently after therapy initiation; checks every 1 to 2 months thereafter.
- Blood samples for lithium levels should be taken in the morning, 12 hours after the last dose.
- Classified as pregnancy category D; crosses the placenta and may result in fetal toxicity.
Side/Adverse Effects
- Common effects include polyuria, polydipsia, anorexia, nausea, and dry mouth.
- Other effects may involve mild thirst, weight gain, abdominal bloating, and diarrhea.
- Neurological impacts can include fine hand tremors, inability to concentrate, muscle weakness, and fatigue.
- Additional symptoms encompass headache, hair loss, and hypothyroidism.
Interventions
- Suicidal clients need careful monitoring, especially when mood improves.
- Administer lithium with food to lessen gastrointestinal upset; avoid diuretics and certain beverages with diuretic effects.
- Alcohol and OTC medications should be avoided.
- For missed doses, clients can take within 2 hours; skip if later.
- Clients should not adjust dosage or stop the medication without health care provider guidance.
- Educate about signs of lithium toxicity and the importance of notifying providers for specific symptoms.
- Clients should maintain hydration with 6-8 glasses of water daily.
Lithium Toxicity
- Occurs when kidneys cannot detoxify and excrete lithium.
- Symptoms emerge when serum lithium levels reach 1.5 to 2 mEq/L.
Mild Toxicity
- Characterized by serum lithium level at 1.5 mEq/L and symptoms like apathy, lethargy, and diminished concentration.
- Additional signs include mild ataxia, coarse hand tremors, and slight muscle weakness.
Moderate Toxicity
- Defined by serum lithium level between 1.5 to 2.5 mEq/L.
- Symptoms include nausea, vomiting, severe diarrhea, and mild to moderate ataxia.
- Other effects may involve slurred speech, tinnitus, blurred vision, and muscle twitching.
Severe Toxicity
- Serum lithium level exceeds 2.5 mEq/L.
- Can cause nystagmus, muscle fasciculations, and hyperreflexia.
- Critical symptoms include hallucinations, oliguria, impaired consciousness, and potential for seizures or coma.
Interventions for Lithium Toxicity
- Immediate cessation of lithium and notification of health care provider is necessary.
- Vital signs and consciousness levels should be closely monitored.
- Cardiac status needs assessment, alongside laboratory tests for lithium, electrolytes, blood urea nitrogen, and creatinine levels.
- Monitor for suicidal tendencies and implement precautionary measures.
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Description
Test your knowledge about lithium with these flashcards. Each card covers key information regarding lithium's interactions, effectiveness, and toxicity. Perfect for students or healthcare professionals seeking to reinforce their understanding of this essential element.
