10/26/2026
🚨 NCLEX PHARMACOLOGY CHALLENGE! 💊🔥
WHEN A MEDICATION BECOMES DANGEROUS!
👉 LET’S LEARN!
Some medications have a narrow therapeutic index, meaning the difference between an effective dose and a toxic dose can be small.
One important example is lithium, commonly used to treat bipolar disorder.
💡 NCLEX MUST-KNOW:
✅ Lithium is eliminated primarily through the kidneys.
✅ Dehydration and sodium depletion can increase lithium levels.
✅ Certain medications, including NSAIDs, ACE inhibitors, and thiazide diuretics, can increase the risk of lithium toxicity.
⚠️ NCLEX TRAP: Don’t focus only on the laboratory value. Always consider the patient’s symptoms and recent medication changes!
🔥 NOW YOUR CLINICAL JUDGMENT CHALLENGE!
A patient with bipolar disorder has been taking lithium for several months.
During the morning assessment, the nurse reviews the following findings:
* Lithium level: 1.3 mEq/L
* Sodium: 132 mEq/L
* Creatinine: 1.6 mg/dL (previously 0.9 mg/dL)
* New coarse hand tremors
* Two episodes of vomiting overnight
The patient recently started taking hydrochlorothiazide.
What is the nurse’s PRIORITY action?
A. Administer the scheduled lithium because the level is only mildly elevated.
B. Encourage oral fluids and reassess the patient after the next lithium dose.
C. Withhold lithium and promptly notify the healthcare provider.
D. Administer the prescribed hydrochlorothiazide to promote sodium excretion.
👇 A, B, C, or D?
⚠️ The laboratory value is only part of the story!
Can you recognize the danger before the condition becomes critical?
