Which condition is an advanced but not severe sign of lithium toxicity Quizlet

3
Impaired social interaction

This patient's behavior relates to interactions with others; therefore, impaired social interaction is the most appropriate diagnosis. Poor reality testing, grandiosity, denial of problems, difficulty organizing and attending to information, poor concentration, and inability to meet basic needs are aspects of coping problems. Impaired verbal communication is a diagnosis that applies to pressured speech, clang associations, and flight of ideas. Defensive coping also relates to denial of problems and grandiosity, but incorporates projection of blame to others and rationalization of own failures; therefore, impaired social interaction is a better diagnosis because of the additional behaviors presented in the scenario.
Text Reference - p. 230, Table 13.2

1
Set reasonable limits on patient behavior.
2
Regularly self-reflect for possible countertransference.
3
Consistently reenforce consequences for inappropriate behavior.
4
Schedule frequent staff meetings to discuss problematic behavior.

People with mania have the ability to staff-split using humor, manipulation, power struggles, or demanding behavior to prevent or minimize the staff's ability to set limits on and control dangerous behavior, or divide the staff into the good guys or the bad guys. This divisive tactic may pit one staff member or group against another, undermining a unified and consistent plan of care. Frequent staff meetings to deal with the behaviors of the patient and the nurses' responses to these behaviors can help minimize staff-splitting. Consistency among staff is imperative if the limit-setting is to be carried out effectively. If one is working with a patient experiencing mania, one may feel helplessness, confusion, or even anger. Understanding, acknowledging, and sharing these responses and countertransference reactions will enhance professional ability to care for the patient and perhaps promote personal development as well. Identifying one staff member to consistently work with the patient would eliminate the environment necessary for splitting.

1
"I really don't need much sleep; two hours a night is enough."
3
"My mother says this outfit is way too sexy but I like it and wear it all the time."
4
"I've telephoned everyone I know and talked for hours; my husband will be mad."
5
"My family is really upset with me but it's just because they're jealous of all I do."

When in full-blown mania, a person constantly goes from one activity, place, or project to another with little or no regard for sleep or food. Inactivity is impossible, even for the shortest period of time. Flowery and lengthy letters are written, and excessive phone calls are made. The behaviors often alienate family, friends, employers, health care providers, and others. Modes of dress often reflect the person's grandiose yet tenuous grasp of reality. Dress may be described as outlandish, bizarre, colorful, and noticeably inappropriate. The statement regarding cooking and eating is not supportive of manic behavior.
Text Reference - pp. 223-224

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"I really don't need much sleep; two hours a night is enough."

"My mother says this outfit is way too sexy but I like it and wear it all the time."

"I've telephoned everyone I know and talked for hours; my husband will be mad."

"My family is really upset with me but it's just because they're jealous of all I do."

When in full-blown mania, a person constantly goes from one activity, place, or project to another with little or no regard for sleep or food. Inactivity is impossible, even for the shortest period of time. Flowery and lengthy letters are written, and excessive phone calls are made. The behaviors often alienate family, friends, employers, health care providers, and others. Modes of dress often reflect the person's grandiose yet tenuous grasp of reality. Dress may be described as outlandish, bizarre, colorful, and noticeably inappropriate. The statement regarding cooking and eating is not supportive of manic behavior.

pp. 223-224

Set reasonable limits on patient behavior.

Regularly self-reflect for possible countertransference.

Consistently reenforce consequences for inappropriate behavior.

Schedule frequent staff meetings to discuss problematic behavior.

People with mania have the ability to staff-split using humor, manipulation, power struggles, or demanding behavior to prevent or minimize the staff's ability to set limits on and control dangerous behavior, or divide the staff into the good guys or the bad guys. This divisive tactic may pit one staff member or group against another, undermining a unified and consistent plan of care. Frequent staff meetings to deal with the behaviors of the patient and the nurses' responses to these behaviors can help minimize staff-splitting. Consistency among staff is imperative if the limit-setting is to be carried out effectively. If one is working with a patient experiencing mania, one may feel helplessness, confusion, or even anger. Understanding, acknowledging, and sharing these responses and countertransference reactions will enhance professional ability to care for the patient and perhaps promote personal development as well. Identifying one staff member to consistently work with the patient would eliminate the environment necessary for splitting.

p. 237

Recommend frequent rest periods during the day

Adequate rest, sleep, and nutrition are essential during mania. The nurse should encourage the manic patient who hasn't slept to take frequent rest periods during the day. Hot tea at bedtime would not be appropriate since tea contains caffeine, which should be avoided. The patient should be encouraged to rest during the day, not remain awake. The patient's environment should be one with low stimulation.

Test-Taking Tip: After you have eliminated one or more choices, you may discover that two of the options are very similar. This can be helpful, because it may mean that one of these look-alike answers is the best choice and the other is a very good distractor. Test both of these options against the stem. Ask yourself which one completes the incomplete statement grammatically and which one answers the question more fully and completely. The option that best completes or answers the stem is the one you should choose. Here, too, pause for a few seconds, give your brain time to reflect, and recall may occur.

p. 232

Impaired social interaction

This patient's behavior relates to interactions with others; therefore, impaired social interaction is the most appropriate diagnosis. Poor reality testing, grandiosity, denial of problems, difficulty organizing and attending to information, poor concentration, and inability to meet basic needs are aspects of coping problems. Impaired verbal communication is a diagnosis that applies to pressured speech, clang associations, and flight of ideas. Defensive coping also relates to denial of problems and grandiosity, but incorporates projection of blame to others and rationalization of own failures; therefore, impaired social interaction is a better diagnosis because of the additional behaviors presented in the scenario.

p. 230, Table 13.2

Which is an advanced but not severe sign of lithium toxicity?

What is an advanced sign of lithium toxicity?

Which of the following is a sign of severe lithium toxicity?

What are mild moderate Signs of lithium toxicity?