Case Study Question 4 of 6 A 23-year-old male with bipolar…

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Cаse Study Questiоn 4 оf 6 A 23-yeаr-оld mаle with bipolar disorder has a health maintenance appointment with the telehealth nurse. Nurses’ Notes   4/1 Telemedicine visit. Client appeared onscreen in a positive mood, was well groomed; shaved; clothes neat, and non- wrinkled. His speech had a normal cadence, was organized, and logical. No slurring or stuttering. Occasional tongue thrusting noted while speaking that was reported to have started  1 day ago. Fine hand tremor noted when client smoothed hair back during conversation. Client reports that he is still attending school and is doing well. He is working a part time job on weekends for local restaurant.  States that he has been taking his meds as directed, he has no thoughts of self- harm, but he has had difficulty sleeping more than a few hours per night.  He complains that he has gained weight (10 lbs / 4.53 kg) recently and has not had the energy to work out. Self-obtained home vital signs of 128/72, HR 82, RR 20. Medications   Medication Dosage/Frequency/ Route         Time Lithium Carbonate 900 mg twice per day by mouth 0800 1800 Risperidone 2 mg once daily at bedtime by mouth 2100   Laboratory Report        Lab Results Reference range Cholesterol (Total) 220 240 mg/dL high BUN 15 10-20 mg/dL Creatine (Serum) 1.2 0.9 to 1.4 mg/dL Glucose (fasting) 125 Normal 126mg/dL Preterm infants 40mg/dL-60mg/dL HgbA1C 5.7% Normal 6.5% Hematocrit 44 Males: 42-52%;Females: 35-47% Hemoglobin 15 Males: 13-18 g/dL; Females:12-16 g/dL WBC 6 4.5 – 10.5 x 103 cells/mm3 Platelets 180,000 140,000 to 450,000/ mm3 Potassium(serum) 4.2 3.5 to 5 mEq/L Sodium (serum) 140 135 to 145 mEq/L Lithium level 0.8 0.8-1.2 mEq/L   The nurse concludes the client is most likely experiencing tardive dyskinesia. Which (2)  interventions should the nurse anticipate to be included in the plan of care?

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