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I need special consederation for Lithium

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by mega-scorpion mega-scorpion (New Member) New Member

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Hello nurses

everybody help me

tha lithium is the drug of choice for manic patients

tell me what the special consederation for lithium when give it and when side effect appear

thanks

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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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: coarse 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

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