護理師針對新診斷為雙相情緒障礙症的個案進行鋰鹽（lithium carbonate）衛教。下列哪項資訊必須包含在指導中？
A nurse is teaching a client with newly diagnosed bipolar disorder about lithium carbonate. Which information is essential to include in the teaching?
- AIncrease caffeine intake to prevent lithium toxicity.增加咖啡因攝取以預防鋰中毒。
- BMaintain a consistent sodium and fluid intake.✓ 正解維持穩定的鈉與水分攝取。
- CTake the medication on an empty stomach for better absorption.空腹服藥以獲得更好的吸收效果。
- DDiscontinue the medication if you feel fine.若感覺良好則停用藥物。
鋰鹽（Lithium carbonate）的安全治療範圍狹窄，且其代謝機轉與鈉離子密切相關。腎臟對鋰鹽與鈉離子的再吸收機制具競爭性，當體內鈉離子濃度降低（如脫水或低鹽飲食）時，腎臟會增加對鋰離子的再吸收，導致血清鋰濃度升高，進而引發鋰中毒（lithium toxicity）。因此，維持恆定的鈉攝取與充足水分是預防中毒的首要衛教重點。臨床護理師應教導個案避免劇烈運動導致大量出汗後的脫水，並監測初期中毒症狀，如震顫、共濟失調或腹瀉。
Lithium carbonate has a narrow therapeutic index, and its metabolism is closely tied to sodium. The renal mechanisms that reabsorb lithium and sodium are competitive: when sodium levels fall (for example, due to dehydration or a low-salt diet), the kidneys reabsorb more lithium, increasing serum lithium levels and the risk of lithium toxicity. Therefore, maintaining consistent sodium intake and adequate hydration is the most important teaching point for preventing toxicity. The nurse should teach the client to avoid dehydration after profuse sweating from strenuous activity and to monitor for early signs of toxicity such as tremor, ataxia, or diarrhea.
在美國臨床，針對長期服用鋰鹽的個案，常規會建立「鋰鹽衛教單張」，並強調定期檢測血清鋰濃度（Serum Lithium Level）。