A client who has liver damage is receiving lithium for treatment of bipolar disorder. The nurse understands that which of the following may occur when the client is receiving lithium?

a) Increased plasma concentration

b) Monitoring of plasma levels is not needed

c) Decreased plasma concentration

d) No alteration in plasma levels

a) Increased plasma concentration

Explanation:

Bipolar disorders are mental disorders in which the patient behaviur, energy and thinking changes dramatically. Lithium is proved to be quite effective in bipolar disorder. But for the best results the concentration of lithium should be kept constant in body. For this the nurses measure the lithium level regularly in the body.

But if a person has liver or kidney disorders plasma concentration of lithium will rise. Kidney and Liver both act as detoxifying and secretory organs of drugs for body. So any damage to them may lead to accumulation of drug in the body.

A. Increased plasma concentration

Explanation:

Due to the fact that liver damage affects its detoxification role, the amount of lithium in the blood build up. The rapid build up and inability of the kidney to clear it (renal clearance) leads to increase in plasma concentration of lithium.

In addition, assuming the damage leads to sodium and volume depletion especially in case of Cirrhosis, this together with inability of the kidney to effectively clear the lithium levels leads to increase in plasma lithium concentration levels of the blood.

Conclusively, the above analysed factors leads to elevation of serum lithium levels.