Question

A manic patient showed progressive improvement with continued lithium therapy. After successful treatment, the patient is discharged from the hospital. What appropriate suggestions should the nurse make to the patient and his or her family during discharge?

a.Water pills or diuretics will help with lithium side effects.
b.You can reduce the lithium dose if there is an excessive weight gain.
c.Over-the-counter medications are safe if taken as instructed on the box.
d.Schedule regular checkups to test the function of your thyroid and kidney.
e.Contact the primary health care provider if there is any excessive vomiting.

Answer 1

Effective discharge counseling for a patient on lithium therapy should emphasize the importance of regular thyroid and kidney function tests, the dangers of modifying lithium dosage or using diuretics, and the necessity to consult healthcare providers before taking any over-the-counter medications. Furthermore, patients should be advised to report symptoms of lithium toxicity such as excessive vomiting immediately.

Step-by-step explanation:

Upon the discharge of a patient who has shown improvement with lithium therapy for a manic episode, it is crucial to provide both the patient and their family with appropriate aftercare suggestions to ensure continued health and safety. First and foremost, the importance of regular monitoring should be emphasized.

Suggesting that the patient schedule regular checkups is vital to test the function of the thyroid and kidney, as lithium can affect these organ systems. Additionally, it is important to educate the patient about the potential side effects and interactions of other medications. Informing them that over-the-counter medications are not always safe and that they should check with their healthcare provider before taking new medication is critical.

Next, the concept of maintaining a consistent treatment regimen is key. Advising the patient against altering the lithium dosage on their own, even in the event of weight gain, is essential to prevent relapse or toxicity. It is also notable that, contrary to a popular misconception, water pills or diuretics are not a suitable method for managing lithium side effects and can lead to dangerous levels of lithium in the blood due to how they affect kidney function and electrolyte balance.

Lastly, the potential signs of lithium toxicity such as excessive vomiting and others should not be taken lightly. Ensuring that the patient and their family are aware that such symptoms necessitate immediate contact with their primary healthcare provider could be life-saving. This level of vigilance is necessary when dealing with such a potent medication as lithium, which has a narrow therapeutic window.