A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

Correct Answer: A

Rationale: In this scenario, the correct action by the nurse is to perform immediate gastric lavage (Option A) for a client with a plasma Lithium level of 2.1 mEq/L. Gastric lavage helps remove the unabsorbed lithium from the stomach, preventing further absorption and reducing toxicity. Lithium toxicity can lead to serious complications such as neurologic symptoms, renal failure, and even death. Gastric lavage is a rapid and effective way to reduce the amount of lithium in the body. Option B, preparing the client for hemodialysis, is not the initial intervention for lithium toxicity. Hemodialysis is considered if the lithium level is extremely high or if the client is experiencing severe symptoms that are not responsive to other treatments. Option C, administering an additional oral dose of lithium, is contraindicated in the case of lithium toxicity as it would further increase the lithium level in the body. Option D, requesting a stat repeat of the laboratory test, may be important for monitoring the client's lithium levels after the initial intervention of gastric lavage. However, in the acute phase of toxicity, immediate action to reduce the lithium level is crucial to prevent harm. In an educational context, understanding the appropriate interventions for lithium toxicity is essential for nurses caring for clients on lithium therapy. Nurses need to be able to recognize the signs of lithium toxicity, know the appropriate interventions, and understand the importance of timely and effective management to ensure positive client outcomes. Regular education and training on pharmacology principles, including drug toxicities and their management, are vital for nursing practice.

Correct Answer: B

Rationale: When administering transdermal Methylphenidate, the patch should be left on for 9 hours per day to ensure optimal absorption and effectiveness of the medication. This duration helps maintain a consistent level of the drug in the child's system. Incorrect options: A) Applying one patch once per day is not the correct dosing regimen for transdermal Methylphenidate. C) The patch should not be applied to the child's waistline as it is recommended to apply it to a clean, dry area. D) Using the opened tray within 6 months is not directly related to the administration of transdermal Methylphenidate.

Correct Answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Furosemide. Furosemide is a loop diuretic that works in the ascending loop of Henle to inhibit sodium and chloride reabsorption, leading to increased urinary excretion of these electrolytes, including potassium. This mechanism can cause hypokalemia, as potassium is also excreted in the urine alongside sodium and chloride. Option A) Captopril and B) Lisinopril are ACE inhibitors, which do not typically cause hypokalemia. Instead, they may lead to hyperkalemia by inhibiting the renin-angiotensin-aldosterone system, which normally promotes potassium excretion. Option D) Spironolactone is a potassium-sparing diuretic that actually helps retain potassium by antagonizing the aldosterone receptor in the distal tubule, thus reducing potassium excretion. In an educational context, understanding the mechanisms of action of different classes of medications is crucial for pharmacology students and healthcare professionals to make informed decisions regarding drug therapy and anticipate potential adverse effects like electrolyte imbalances. This knowledge is essential for safe medication administration and effective patient care.

Correct Answer: C

Rationale: The correct instruction for a client starting Metoprolol is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, leading to dizziness and falls if the client changes positions quickly. By advising the client to make position changes slowly, the nurse helps prevent these adverse effects and promotes safety.