Final Answer:
The nurse should instruct the client to consume a low-sodium diet (Option B).
Step-by-step explanation:
Lithium is a mood stabilizer commonly prescribed for bipolar disorder. Maintaining a consistent intake of sodium is crucial for the effectiveness and safety of lithium. Sodium levels in the body affect lithium absorption, and fluctuations can lead to toxicity or reduced efficacy. A low-sodium diet helps maintain stable lithium levels, preventing adverse effects.
Sodium competes with lithium for renal reabsorption. An increase in sodium intake can lead to increased reabsorption of sodium by the kidneys, reducing the reabsorption of lithium. This results in higher lithium excretion, potentially leading to subtherapeutic levels and decreased effectiveness of the medication. On the other hand, a low-sodium diet helps retain lithium, optimizing its therapeutic effects.
Other options are contraindicated. Increased caffeine intake (Option A) can lead to dehydration, increasing the risk of lithium toxicity. Grapefruit juice (Option C) can interfere with the metabolism of certain medications but is not relevant to lithium. Skipping doses when feeling overly energetic (Option D) is unsafe, as abrupt discontinuation can trigger mood swings and worsen the condition. Therefore, emphasizing a low-sodium diet is crucial in lithium management for individuals with bipolar disorder.
The correct option is b.