There are well-known side effects of lithium which includes: gastrointestinal symptoms such as dyspepsia, nausea, vomiting, and diarrhea, as well as weight gain, hair loss, acne, tremor, sedation, decreased cognition, and incoordination. When considering a patient receiving long-term treatment of Lithium, what organs may be impacted by this medication regarding potential adverse effects? (Select all that applies).

A. Kidney: Long-term lithium therapy can impair renal function, leading to nephrogenic diabetes insipidus and, in some cases, chronic kidney disease. Monitoring renal function through serum creatinine and estimated glomerular filtration rate is essential during prolonged treatment. B. Thyroid: Lithium can interfere with thyroid hormone synthesis, increasing the risk of hypothyroidism and goiter. Regular monitoring of thyroid-stimulating hormone (TSH) and free T4 is recommended for patients on long-term therapy. C. Lungs: The lungs are not a primary target for lithium toxicity or long-term adverse effects. Pulmonary complications are not commonly associated with lithium therapy. D. Lymph nodes: Lithium does not directly impact lymph node function or structure. Lymphadenopathy is not a recognized side effect of lithium treatment.