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ATI Chapter 23: Medications for Bipolar Disorders

Key Concepts:

Terms in this set (41)

- monitor plasma lithium levels while undergoing treatment. At initiation of treatment, monitor levels every 2 to 3 days until stable and then every 1 to 3 months. Closely monitor levels after any dosage change. Lithium blood levels should be obtained in the morning, 8 to 12 hours after last dose
-> during initial treatment of a manic episode, levels should be 0.8 to 1.4 mEq/L
-> maintenance level range is 0.4 to 1.0 mEq/L
-> plasma levels greater than 1.5 mEq/L can result in toxicity
- older adult clients are at an increased risk for toxicity and require more frequent monitoring of serum lithium levels
- care for a client who has a toxic plasma lithium level should take place in an acute care setting with supportive measures provided. Hemodialysis can be indicated
- advise the client that effects begin within 5 to 7 days. Maximum benefits might not be seen for 2 to 3 weeks
- Advise the client to take lithium as prescribed. This medication must be administered in 2 to 3 doses daily due to a short half-life. Taking lithium with food will help decrease GI distress
- encourage that client to adhere to laboratory appointments needed to monitor lithium effectiveness and adverse effects. Emphasize the high risk of toxicity due to the narrow therapeutic range.
- provide nutritional counseling. Stress the importance of adequate fluid and sodium intake
- instruct the client to monitor for indications of toxicity withhold the medication and seek medical attention if she is experiencing diarrhea, vomiting, or excessive sweating