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Early signs of toxicity
GI upset
course hand tremor
confusion
hyperirritability of muscles
EKG changes
sedation and incoordination
Advancing toxicity
Ataxia
Foddiness
blurred vision
clinical movements
EKG changes
Polyuria
Seizures
Stupor
Severe hypotension and coma
death is typically secondary to pulmonary complication
Severe toxicity
convulsions
oliguria
possibly death
Education
nonaddictive
mood stabilization and relapse
slow onset
monitoring blood levels is key
monitor i&O’s
monitor things that can lead to dehydration
Nausea, vomiting diarrhea, thirst, polyuria, lethargy, sedation, fine hand tremor - known side effects
monitor thyroid, parathyroid and renal function
initial water weight gain
Therapeutic levels of Lithium
0.6 - 1.2 MEQ
Early toxicity levels
1.5 - 2
Advancing toxicity levels
2.0 - 2.5 MEQ
Severe toxicity levels
greater than 2.5 MEQ