SOLVED503

Nurses’ Notes 1000: Client transferred to the mental health unit from the emergency department. Reports vomiting and diarrhea for the past 3 days, and recent development of muscle twitching. Notable slurring of speech and drowsiness during admission interview. 1030: Reviewed diagnostic results and medication administration record. 1515: Client vomited, requesting ginger ale to drink. Speech remains slurred, BP has dropped from 140/80 mm Hg at 1000 to 110/66 mm Hg. Diagnostic Results 1030: Sodium 131 mEq/L (136 to 145 mEq/L) Potassium 4.2 mEq/L (3.5 to 5 mEq/L) Glucose 100 mg/dl (74 to 106 mg/dL) Lithium 2.2 mEq/L (Therapeutic level: 0.8 to 1.2 mEq/L, toxic level: greater than 2 mEq/L) WBC count 12,500/mm* (5,000 to 10,000/mm*) Thyroid-stimulating hormone (TSH) 0.34 microunits/mL (0.3 to 6 microunits/mL) Medication Administration Record Lithium 600 mg PO three times dally Furosemide 40 mg PO daily Ibuprofen 400 mg PO every three times daily PRN joint pain Prochlorperazine 20 mg IM every 3 to 4 hr PRN nausea Medical History Has had bipolar I disorder for the past 10 years. Smokes one pack of cigarettes a day; reduced from two packs a day from 1 year ago. Hospitalized for heart failure 1 month ago. The nurse is
SCIENCE
HEALTH SCIENCE
NURSING

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