Michelle, a 32-year-old female with a history

Michelle, a 32-year-old female with a history of bipolar disorder, has stopped taking her valproic acid (Depakote). She is brought to the hospital because she has become increasingly hyper-excitable over the past 3 days. She has talked on the phone almost continuously as she is trying to start a new business. She has called friends and family all over the county at all hours of the night. Her husband was called when she tried to purchase a car, and the bank reported her for writing bad checks. She is brought to the hospital in an acute manic state. During her hospital stay her physician has ordered for her to begin taking Lithium 300 mg. 3x daily. 1. Why might have Michelle have stopped taking her medication? 2. Explain the role of sodium intake when taking Lithium. 3. Why is it important for patients on lithium to have lithium levels checked? What is the therapeutic range of lithium for patients on maintenance therapy?

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