A nurse is caring for a client who has been taking lithium mg PO daily. Which of the following client statements requires follow-up by the nurse?

Choice A reason: This statement reflects appropriate caution. Many over-the-counter medications can interact with lithium or affect renal function, so consulting the prescriber is a safe practice. Choice B reason: Excessive intake of salty foods can alter sodium levels and affect lithium excretion. High sodium intake may reduce lithium levels, while sudden changes can destabilize the balance and increase toxicity risk. This behavior requires follow-up to ensure dietary consistency and safe lithium management. Choice C reason: Routine bloodwork every 3 months is standard for monitoring lithium levels and renal function. This statement reflects adherence to safety protocols and does not require follow-up. Choice D reason: Maintaining adequate hydration is essential for lithium safety. This statement reflects good self-care and understanding of lithium’s renal excretion pathway. It does not require follow-up.