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Asked by dolad2012
 CASE STUDY:
Mrs. Smith, a 70-year-old white woman, is admitted from the emergency department to the neurological unit with a variety of concerning symptoms. She was found on the floor in her apartment by a neighbor. She exhibited acute mental status changes and was very lethargic. The neighbor was not sure how long she was “down.” At the time of the admission assessment on the unit, Mrs. Smith cannot follow simple commands, track the examiner, and is nonverbal. She also has a generalized tremor. A single dose of an antiepileptic drug had been given in the emergency department for concern of possible seizure activity. Her medical history is hypertension, antidepressant, Parkinson’s disease, osteoarthritis, slight obesity, and bipolar disorder for which she is prescribed lithium and has taken this for more than 15 years. Mrs. Smith’s current lithium level is elevated at 2.1 mEq/L, greater than the maximum therapeutic level of 1 to 1.5 mEq/L. After a negative head computed tomography and a thorough examination, the physician considers several possibilities.
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UESTIONS:
What significant nursing assessments would you include?
What nursing diagnosis would be appropriate for this patient?
What medications could possibly interfere with lithium that she is taking for her mood disorder?
What parameters would you monitor in Mrs. Smith’s labs? TIP – urine, glucose and serum level
Discuss a few nursing interventions.
What information needs to be included in the teaching plan for this patient?
What dietary recommendations would you make? What should the patient avoid?
How would you evaluate this patient? Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â MEDICATION HISTORY:Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â DIET:
    Hydrochlorothiazide                        Drinks coffee two times a day
    Methyldopa                               Eats out 5 times a day, fast food
    Ibuprofen
    FluoxetineÂ
SCIENCE
HEALTH SCIENCE
NURSING
PHARMACY 116
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