مريض على ليثيوم، مستواه ٢٫١ مليمول/لتر، مع قيء ورعشة خشنة. ما التصرف الصحيح؟

A client on lithium has a level of 2.1 mmol/L with vomiting and a coarse tremor. What is correct?

1. Give the dose with food
2. Hold the dose and notify the provider immediately
3. Increase fluids and give the dose
4. Give the dose with a diuretic

Answer: B) Hold the dose and notify the provider immediately. The therapeutic range is about 0.6–1.2; 2 or above is moderate-to-severe toxicity, and diuretics raise lithium levels.