Question

A nurse is reviewing routine laboratory values for several patients who are taking lithium carbonate. Which of the following patients should the nurse assess further for findings indicating lithium toxicity?

1. A client who has a fasting blood glucose level of 80 mg/dl
2. A client who has a sodium level of 128 mEq/L
3. A client who has a BUN of 18 mg/dL
4. A client who has a potassium level of 3.6 mEq/L

Answer 1

The patient with a sodium level of 128 mEq/L should be assessed further for lithium toxicity because hyponatremia can increase the risk of accumulating lithium in the body.

Step-by-step explanation:

The nurse should assess further for findings indicating lithium toxicity in the patient who has a sodium level of 128 mEq/L. Normal sodium levels are generally between 135-145 mEq/L, and the patient's level is low, indicating hyponatremia. Lithium can affect sodium levels in the body and compete with it for reabsorption in the kidneys. When the sodium level is low, the kidneys may reabsorb more lithium, possibly leading to an accumulation of lithium and subsequent toxicity. Therefore, hyponatremia can be a risk factor for lithium toxicity. The other lab values given, such as fasting blood glucose, BUN (blood urea nitrogen), and potassium level, are within normal ranges and are less likely to be associated with lithium toxicity in the context provided.