I need special consederation for Lithium

Daytonite, BSN, RN · Apr 17, 2009

from page 615, 2007 mosby's nursing drug reference:

nursing considerations

assess:
- weight daily; check for and report edema in legs, ankles, wrists
- sodium intake; decreased sodium intake with decreased fluid intake may lead to lithium retention; increased sodium and fluids may decrease sodium lithium retention
- skin turgor at least daily
- urine for albuminuria, glycosuria, uric acid during beginning treatment, q2mo thereafter
- neurologic status; loc, gait motor reflexes, hand tremors
- serum lithium levels qwk initially, then q2mo (therapeutic level: 0.5-1.5 meq/l)
[*]administer:
- do not break, crush, or chew caps, ext red tabs
- reduced dose to elderly
- with meals to avoid gi upset
- adequate fluids (2-3 l/day) to prevent dehydration during initial treatment, 1-2 l/day during maintenance
[*]evaluate:
- therapeutic response: decrease in excitement, manic phase
[*]teach patient/family:
- the symptoms of minor toxicity: vomiting, diarrhea, poor coordination, fine motor tremors, weakness, lassitude; major toxicity: coorifice tremors, severe thirst, tinnitus, diluted urine
- to monitor urine specific gravity, emphasize need for follow up care to determine lithium levels; monitor lithium levels to ensure effective levels and treatment
- that contraception is necessary, since lithium may harm fetus
- not to operate machinery until lithium levels are stable
- that beneficial effects may take 1-3 weeks
- about drugs that interact with lithium (provide list) and discuss need for adequate stable intake of salt and fluids
[*]treatment of overdose:
- induce emesis or lavage, maintain airway, respiratory function; dialysis for severe intoxication

also see http://www.drugs.com/pro/lithium.html

mega-scorpion · Apr 17, 2009

Thanks Alot for your replay

thanks