Question

Use the following scenario to answer the questions below. A patient who has bipolar disorder has been started on Lithium. He is also on paroxetine, (Paxil), digoxin, furosemide, (Lasix), and potassium supplements for depression, hypertension, and heart failure. He has also been placed on a low-sodium diet. 6. During the first 3 weeks on lithium, what would the nurse identify as a priority nursing diagnosis? 7. What assessments would the nurse make in identifying the diagnosis? 8. What is the patient goal for the first 3 weeks of therapy?

Answer 1

During the first 3 weeks on lithium, a priority nursing diagnosis would be risk for lithium toxicity. The nurse would need to closely monitor the patient's lithium levels to ensure they are within the therapeutic range and prevent toxicity. The patient goal for the first 3 weeks of therapy would be to establish a therapeutic lithium level within the target range.

Step-by-step explanation:

During the first 3 weeks on lithium, a priority nursing diagnosis would be risk for lithium toxicity. Lithium has a narrow therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose is small. The nurse would need to closely monitor the patient's lithium levels to ensure they are within the therapeutic range and prevent toxicity.

In identifying the diagnosis, the nurse would assess the patient's lithium levels, as well as their renal function, since lithium is primarily excreted by the kidneys. Other assessments would include monitoring for signs and symptoms of lithium toxicity, such as hand tremors, confusion, and excessive thirst.

The patient goal for the first 3 weeks of therapy would be to establish a therapeutic lithium level within the target range. This would require regular monitoring of lithium levels and adjustment of the dosage as necessary to achieve the desired therapeutic effect.