A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

Choice A reason: Checking the client’s medication record is not necessary in this situation. The lithium level is therapeutic at 1.0 mEq/L, and there is no indication of refusal or noncompliance. While reviewing medication records is part of routine care, it does not directly address the current scenario. Choice B reason: Administering the morning dose of lithium is appropriate. A level of 1.0 mEq/L is within the therapeutic range (0.6–1.2 mEq/L). This indicates that the client is maintaining safe and effective drug levels. Continuing the prescribed regimen ensures stability in mood management and prevents relapse of bipolar symptoms. Choice C reason: Preparing for gastric lavage is unnecessary. Gastric lavage is indicated in cases of acute toxicity or overdose. A lithium level of 1.0 mEq/L is not toxic and does not warrant emergency intervention. Choice D reason: Holding the medication and assessing for toxicity is inappropriate because the lithium level is not elevated. Toxicity typically occurs at levels above 1.5 mEq/L, with early signs including nausea, vomiting, tremors, and confusion. Since the client’s level is therapeutic, withholding the medication would risk destabilizing treatment.