A nurse is caring for a client who is taking lithium and reports experiencing lethargy, muscle weakness, and blurred vision. Which of the following responses should the nurse make?

Choice A reason: Lethargy, muscle weakness, and blurred vision suggest lithium toxicity, requiring immediate blood levels to confirm (therapeutic range: 0.6-1.2 mEq/L). Toxicity risks escalate with dehydration or overdose, common in bipolar treatment. Drawing blood assesses severity, guiding urgent action like dose adjustment or cessation, prioritizing safety and making this the correct response. Choice B reason: Assuring symptoms improve over time dismisses potential lithium toxicity, a serious risk needing evaluation, not patience. These signs don’t typically self-resolve without intervention, and delaying risks neurological or renal damage. This response ignores clinical urgency, endangering the client, so it’s inappropriate and unsafe. Choice C reason: Decreasing sodium worsens lithium toxicity, as low sodium increases lithium retention by the kidneys, elevating levels. These symptoms indicate excess, not deficiency, needing assessment, not dietary change. This advice contradicts pharmacology, potentially harming the client further, making it incorrect. Choice D reason: Continuing lithium as prescribed ignores toxicity signs—lethargy, weakness, vision changes—potentially leading to severe outcomes like seizures. Without blood levels, this risks progression, neglecting the need for immediate evaluation. It’s a dangerous response, bypassing critical assessment, so it’s not suitable.