{"id":5200,"date":"2024-08-09T23:06:00","date_gmt":"2024-08-09T23:06:00","guid":{"rendered":"https:\/\/nurs.essaybishops.com\/?p=5200"},"modified":"2024-08-09T23:07:19","modified_gmt":"2024-08-09T23:07:19","slug":"lithium-poisoning-toxicology-case-study","status":"publish","type":"post","link":"https:\/\/www.homeworkacetutors.com\/nursing\/lithium-poisoning-toxicology-case-study\/","title":{"rendered":"Lithium Poisoning Toxicology Case Study"},"content":{"rendered":"<h3><strong>Lithium Poisoning Toxicology Case Study.<\/strong><\/h3>\n<p>Pharmacology case study;<br \/>\nHistory: A 53 year-old-female presents to the emergency department with her<br \/>\nneighbor who is concerned that she has been disoriented for the past<br \/>\nweek. The patient is unable to provide any history except to say that she is<br \/>\nhaving mild cramping abdominal pain. The neighbor relates that the<br \/>\npatient\u2019s entire family was ill the week prior to symptom onset with a<br \/>\ndiarrheal illness that lasted for 5 days.<br \/>\nPMH: Hypertension, stage I kidney disease, bipolar disorder, anxiety<br \/>\nMedications: Hydrochlorothiazide, enalaprilat, lithium, clonazepam prn<br \/>\nPhysical Examination:<br \/>\nT: 97.9\u00b0F HR: 108 bpm RR 14 breaths per minute BP: 125\/76 mmHg<br \/>\nGeneral: Disheveled female in no acute distress. Oriented to person only.<br \/>\nHEENT: Pupils equal, round and reactive to light. Mucous membranes tacky.<br \/>\nCV: Tachycardic, regular rhythm. No murmurs.<br \/>\nPulmonary: Clear to auscultation.<br \/>\nAbdomen: Normal bowel signs. Soft, with mild, diffuse tenderness. No guarding or<br \/>\nrebound.<br \/>\nNeurologic: Cranial nerves II \u2013 XII intact. Motor testing is 4\/5 diffusely, but symmetric.<br \/>\nGait examination reveals ataxia. No clonus or hyperreflexia.<br \/>\nED course: the patient underwent a full laboratory evaluation that showed a creatinine<br \/>\nof 2.1 (baseline 1.4) and a lithium level of 14 mg\/dL.<br \/>\nShe was admitted for lithium toxicity, which was thought to result from worsening renal dysfunction after an episode of gastroenteritis.<\/p>\n<p>Case Study Questions:<br \/>\n1. Describe common laboratory and physical exam findings in patients with chronic<br \/>\nand acute lithium poisoning.<br \/>\n2. What are indications for hemodialysis in lithium toxicity? Are there different<br \/>\nindications depending on whether the presentation is the result of acute versus<br \/>\nchronic exposure?<\/p>\n<p>Toxicology case study: Lithium poisoning;<br \/>\n1. Chronic lithium exposures can present with systemic symtoms such as lethargy,<br \/>\nmuscular weakness, slurred speech, ataxia, tremor, and myoclonic jerks.<br \/>\nSevere intoxication can cause delirium, coma, convulsions, and hyperthermia.<br \/>\nPatients with chronic lithium poisoning can also develop nephrogenic diabetes<br \/>\ninsipidus. Lithium levels may be only slightly above normal. Other laboratory<br \/>\nfindings can include leukocytosis. The ECG may show T wave flattening or<br \/>\ninversion, QT prolongation, ST depression in lateral leads, and sinus<br \/>\nbradycardia.<br \/>\nAcute lithium exposures commonly present with nausea and vomiting. Systemic<br \/>\nsymptoms are delayed for several hours while lithium distributes into tissues<br \/>\nsince it can take lithium about 6-8 hours to be completely absorbed. Initial<br \/>\nlithium levels will be high in an acute intoxication and may fall once it is absorbed<br \/>\ninto the tissues. Other labs to obtain include electrolytes and renal function<br \/>\ntests.<br \/>\n2. Lithium is excretion is exclusively by the kidneys. Hemodialysis should be used<br \/>\nfor patients with severe symptoms such as abnormal mental status and seizures,<br \/>\nfor patients who cannot excrete lithium due to renal disease and patients who<br \/>\ncannot tolerate aggressive fluid resucitations (ex. heart failure). Treatment should<br \/>\nbe based on clinical presentation and not laboratory values.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Lithium Poisoning Toxicology Case Study. Pharmacology case study; History: A 53 year-old-female presents to the emergency department with her neighbor who is concerned that she has been disoriented&hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1304,414,1192,1634],"tags":[1638,1636,1635,1637],"class_list":["post-5200","post","type-post","status-publish","format-standard","hentry","category-help-write-my-toxicology-case-study-assignment","category-advanced-pharmacology","category-case-study-answers-for-advanced-pharmacology","category-written-pharmacology-case-study-examples","tag-hemodialysis","tag-lithium-poisoning","tag-pharmacology-assignment","tag-toxicology-case-study"],"_links":{"self":[{"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/posts\/5200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/comments?post=5200"}],"version-history":[{"count":2,"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/posts\/5200\/revisions"}],"predecessor-version":[{"id":5202,"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/posts\/5200\/revisions\/5202"}],"wp:attachment":[{"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/media?parent=5200"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/categories?post=5200"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/nursing\/wp-json\/wp\/v2\/tags?post=5200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}