A client diagnosed with bipolar disorder has taken lithium carbonate (Lithane) for 1 year; this client presents in an emergency department with severe diarrhea, blurred vision, and tinnitus. The nurse should interpret these symptoms to be indicative of which of the following?

Correct Answer: D

Rationale: The correct answer is D: Lithium carbonate toxicity. The symptoms of severe diarrhea, blurred vision, and tinnitus are indicative of lithium toxicity. Severe diarrhea can lead to dehydration, which can exacerbate lithium toxicity. Blurred vision and tinnitus are neurological symptoms associated with lithium toxicity. It is important for the nurse to recognize these symptoms as signs of lithium toxicity and take appropriate action. A: Consumption of foods high in tyramine is not related to the symptoms described. Tyramine is not known to cause severe diarrhea, blurred vision, or tinnitus. B: Common side effects of lithium carbonate typically include mild gastrointestinal upset, tremors, and increased thirst, not the severe symptoms described in the question. C: Lithium carbonate tolerance refers to the body's ability to withstand higher doses of lithium over time. It does not present with the acute, severe symptoms described in the question.

Correct Answer: B

Rationale: The correct answer is B because diarrhea and ringing in the ears are common side effects of lithium carbonate that require immediate medical attention. This demonstrates the client's understanding of the importance of monitoring for potential adverse effects. Option A is incorrect as lithium carbonate may take weeks to show full effects. Option C is incorrect as doubling the dose can lead to toxicity. Option D is incorrect as lithium does not require salt restriction.

Correct Answer: B

Rationale: The correct initial action is B: Take the child swimming at the facility's pool. This option is best as it provides a physical outlet for the child's anger and helps to de-escalate the situation in a calming and non-confrontational manner. Swimming can be a therapeutic activity that helps release tension and promote relaxation. Asking the child to express feelings (A) may not be effective in the heat of the moment. Establishing a behavioral contract (C) may be premature and not address the immediate need for de-escalation. Administering medication (D) should not be the first response and is not appropriate for managing situational anger outbursts.

Correct Answer: C

Rationale: The correct answer is C because medication is not typically the first-line treatment for Oppositional Defiant Disorder (ODD). Behavioral strategies, such as therapy and counseling, are usually recommended to address the underlying issues causing the behavior. Medication may be considered in certain cases but is not the primary treatment. Choice A is incorrect because while ODD is primarily behavioral, there are cases where medication may be used as an adjunct treatment. Choice B is incorrect as it dismisses the importance of understanding individual treatment approaches. Choice D is incorrect as it provides inaccurate information and may raise false hopes about medication being the solution.

Correct Answer: A

Rationale: The correct answer is A because measurement involves quantifying and analyzing data in numerical terms to understand a phenomenon objectively. In contrast, diagnosis is the process of identifying and labeling a patient's condition based on symptoms and test results to determine the appropriate treatment plan and prognosis. Choice B is incorrect because diagnosis does not involve numerical analysis but rather focuses on identifying and classifying illnesses. Choice C is incorrect as diagnosis and measurement are distinct processes with different objectives and methods. Choice D is incorrect as SOAP notes are used in documenting patient progress and treatment, not specifically for measurement. Physical therapy guides may assist in diagnosis but are not exclusive to it.