{"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.colapapers.com\/nursing\/lithium-poisoning-toxicology-case-study\/","title":{"rendered":"Lithium Poisoning Toxicology Case Study"},"content":{"rendered":"

Lithium Poisoning Toxicology Case Study.<\/strong><\/h3>\n

Pharmacology case study;
\nHistory: A 53 year-old-female presents to the emergency department with her
\nneighbor who is concerned that she has been disoriented for the past
\nweek. The patient is unable to provide any history except to say that she is
\nhaving mild cramping abdominal pain. The neighbor relates that the
\npatient\u2019s entire family was ill the week prior to symptom onset with a
\ndiarrheal illness that lasted for 5 days.
\nPMH: Hypertension, stage I kidney disease, bipolar disorder, anxiety
\nMedications: Hydrochlorothiazide, enalaprilat, lithium, clonazepam prn
\nPhysical Examination:
\nT: 97.9\u00b0F HR: 108 bpm RR 14 breaths per minute BP: 125\/76 mmHg
\nGeneral: Disheveled female in no acute distress. Oriented to person only.
\nHEENT: Pupils equal, round and reactive to light. Mucous membranes tacky.
\nCV: Tachycardic, regular rhythm. No murmurs.
\nPulmonary: Clear to auscultation.
\nAbdomen: Normal bowel signs. Soft, with mild, diffuse tenderness. No guarding or
\nrebound.
\nNeurologic: Cranial nerves II \u2013 XII intact. Motor testing is 4\/5 diffusely, but symmetric.
\nGait examination reveals ataxia. No clonus or hyperreflexia.
\nED course: the patient underwent a full laboratory evaluation that showed a creatinine
\nof 2.1 (baseline 1.4) and a lithium level of 14 mg\/dL.
\nShe was admitted for lithium toxicity, which was thought to result from worsening renal dysfunction after an episode of gastroenteritis.<\/p>\n

Case Study Questions:
\n1. Describe common laboratory and physical exam findings in patients with chronic
\nand acute lithium poisoning.
\n2. What are indications for hemodialysis in lithium toxicity? Are there different
\nindications depending on whether the presentation is the result of acute versus
\nchronic exposure?<\/p>\n

Toxicology case study: Lithium poisoning;
\n1. Chronic lithium exposures can present with systemic symtoms such as lethargy,
\nmuscular weakness, slurred speech, ataxia, tremor, and myoclonic jerks.
\nSevere intoxication can cause delirium, coma, convulsions, and hyperthermia.
\nPatients with chronic lithium poisoning can also develop nephrogenic diabetes
\ninsipidus. Lithium levels may be only slightly above normal. Other laboratory
\nfindings can include leukocytosis. The ECG may show T wave flattening or
\ninversion, QT prolongation, ST depression in lateral leads, and sinus
\nbradycardia.
\nAcute lithium exposures commonly present with nausea and vomiting. Systemic
\nsymptoms are delayed for several hours while lithium distributes into tissues
\nsince it can take lithium about 6-8 hours to be completely absorbed. Initial
\nlithium levels will be high in an acute intoxication and may fall once it is absorbed
\ninto the tissues. Other labs to obtain include electrolytes and renal function
\ntests.
\n2. Lithium is excretion is exclusively by the kidneys. Hemodialysis should be used
\nfor patients with severe symptoms such as abnormal mental status and seizures,
\nfor patients who cannot excrete lithium due to renal disease and patients who
\ncannot tolerate aggressive fluid resucitations (ex. heart failure). Treatment should
\nbe based on clinical presentation and not laboratory values.<\/p>\n","protected":false},"excerpt":{"rendered":"

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 for the past week. The patient is unable to provide any history except to say that she is having mild cramping abdominal pain. The neighbor relates that […]<\/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.colapapers.com\/nursing\/wp-json\/wp\/v2\/posts\/5200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/comments?post=5200"}],"version-history":[{"count":2,"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/posts\/5200\/revisions"}],"predecessor-version":[{"id":5202,"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/posts\/5200\/revisions\/5202"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/media?parent=5200"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/categories?post=5200"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/nursing\/wp-json\/wp\/v2\/tags?post=5200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}