A 23-year-old pregnant woman has been referred to the PMHNP by her OB/GYN for management of bipolar disorder. Lithium should be avoided in the first trimester due to which potential teratogenic risk?

Choice A reason: Neural tube defects are commonly associated with folate deficiency and medications like valproic acid or carbamazepine, not lithium. Choice B reason: Ebstein's anomaly is a congenital heart defect involving the tricuspid valve and is the most well-documented teratogenic risk associated with lithium exposure during the first trimester. It is rare but serious, making this the correct answer. Choice C reason: Cleft palate is associated with various teratogens, including phenytoin and alcohol, but not typically with lithium. Choice D reason: Floppy baby syndrome refers to hypotonia in infants and is most commonly linked to maternal benzodiazepine use, not lithium.