Question

Richard is a 25 y.o. male patient who is being admitted to the inpatient mental health...

Richard is a 25 y.o. male patient who is being admitted to the inpatient mental health unit. He has a diagnosis of Bipolar 1 disorder. He has no history of physical or medical illnesses. During the admission assessment, Richard indicates that when he was 21 y.o., he was treated for bipolar 1 as an outpatient in the hospital clinic. He indicates was prescribed Carbamazepine but stopped taking it about 1 year ago. He told the nurse he has recently moved to the city as a mechanic, lives with a close relative temporarily. He does not have any friends in the city. About 3 weeks ago he had a surge of energy, was working 14-hour days and was up at night for days. During the interaction Richard often talked about his past depression and suicidality. Over the past month he has lost 15 lbs., has difficulty eating and has no appetite. He does not have the”…energy to get out of bed..” and has missed 4 days of work in the past week. He acknowledges having thoughts of ending his life by “driving off the road”. However, he says he is uncertain and afraid that if he takes his own life he will go to hell. You are the nurse assigned to provide care to Richard.

What are some signs and symptoms of lithium toxicity?

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Answer #1

LITHIUM TOXICITY

Lithium toxicity occurs when you take too much lithium, a mood stabilizing medication used to treat bipolar disorder and major depressive disorder. Lithium toxicity is also known as lithium overdose

The right dose of lithium varies from person to person, but most people are prescribed between 900 mg to 1000 mg per day.

A safe blood level of lithium is 0.6 and 1.2 mEq .lithium toxicity can happen when this level reaches 1.5 mEq or higher. Severe toxicity can happen at a level of 2.0 mEq/L or more

SIGNS AND SYMPTOMS OF LITHIUM TOXICITY

1. Mild to moderate toxicity

  • Diarhoea
  • Vomiting
  • Stomach pain
  • Fatigue
  • Tremor
  • Uncontrollable movements
  • Muscle weakness
  • Drowsiness
  • Weakness

2. Severe toxicity

  • Heightened reflexes
  • Seizures
  • Agitation
  • Slurred speech
  • Kidney failure
  • Rapid heartbeat
  • Hyperthermia
  • Uncontrollable eye movements
  • Low blood pressure
  • Confusion
  • Coma
  • Delirium
  • Death.
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