Page 2361 - Saunders Comprehensive Review For NCLEX-RN

a. Serum lithium level of 1.5 to 2.0 mEq/L
(1.5 to 2.0 mmol/L)
b. Nausea, vomiting
c. Severe diarrhea
d. Mild to moderate ataxia and
incoordination
e. Slurred speech
f. Tinnitus
g. Blurred vision
h. Muscle twitching
i. Irregular tremor
4. Severe toxicity
a. Serum lithium level greater than 2.0
mEq/L (2.0 mmol/L)
b. Nystagmus
c. Muscle fasciculations
d. Deep tendon hyper-reflexia
e. Visual or tactile hallucinations
f. Oliguria or anuria
g. Impaired level of consciousness
h. Tonic-clonic seizures or coma, leading
to death

5. Interventions for lithium toxicity

a. Withhold lithium and notify the PHCP.
b. Monitor vital signs and level of
consciousness.
c. Monitor cardiac status.
d. Prepare to obtain samples to monitor
lithium, electrolyte, blood urea
nitrogen, and creatinine levels and
perform a complete blood cell count.
e. Monitor for suicidal tendencies and
institute suicide precautions.
V. Antianxiety or Anxiolytic Medications
A. Description
1. Antianxiety medications depress the CNS, increasing
the effects of GABA, which produces relaxation and
may depress the limbic system.
2. Benzodiazepines have anxiety-reducing (anxiolytic),
sedative-hypnotic, muscle-relaxing, and
anticonvulsant actions (Box 68-6).
3. Benzodiazepines are contraindicated in clients with
acute narrow-angle glaucoma and should be used
cautiously in children and older adults.
4. Benzodiazepines interact with other CNS medications,
producing an additive effect, and therefore should
only be considered for short-term use.

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