👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Pharmacological Therapies🔖 Free to read, print, and share
Also known as: lithium · mood stabilizer · bipolar medicine · lithium carbonate
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Use this quick-reference guide to spot, treat, and prevent Lithium on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
🧪 Labs
Therapeutic: 0.6–1.2 mEq/L
Toxic > 1.5 mEq/L → hold
Narrow therapeutic window
🩺 Signs
Early tox: N/V, tremor, diarrhea
Severe: confusion, ataxia, seizures
🎓 Teach
Steady salt + fluid intake
↓Na or dehydration → ↑lithium
Avoid NSAIDs, thiazides
🧪 Monitor
Draw level 12h post-dose
Check thyroid + renal function
📚 Lithium — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Lithium is a mood stabilizer used for bipolar disorder, especially to control acute mania and prevent relapse. It has a very narrow therapeutic range, so blood levels must be monitored closely and toxicity is a constant concern. Memory aid: lithium and sodium 'compete' — low sodium or dehydration raises lithium levels and causes toxicity.
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Key points
Understand these first
The therapeutic serum level is narrow (about 0.6-1.2 mEq/L); levels above 1.5 mEq/L are toxic.
Sodium and fluid balance directly affect lithium levels: low sodium, dehydration, or diuretics raise lithium and cause toxicity.
Early toxicity signs include nausea, vomiting, diarrhea, fine tremor, and thirst.
TSH (0.4-4.0 mIU/L) and creatinine for long-term monitoring
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Patient teaching
What patients must know
Maintain a steady salt intake and drink plenty of water; do not crash diet or restrict salt.
Report vomiting, diarrhea, or excessive sweating because they can cause toxicity.
Keep all blood-level appointments and learn the early signs of toxicity such as tremor and confusion.
❓ Lithium: NCLEX FAQs
What are the priority nursing interventions for Lithium?
Monitor serum lithium levels regularly and report levels at or above 1.5 mEq/L. Ensure consistent dietary sodium and adequate fluid intake (about 2-3 liters/day). Assess for early signs of toxicity at each contact. Monitor thyroid and renal function during long-term therapy.
What are the warning signs of Lithium a nurse must report?
Serum lithium at or above 1.5 mEq/L, or any coarse tremor, confusion, ataxia, or slurred speech. Vomiting, diarrhea, fever, or sweating that can cause dehydration and rapidly raise lithium levels. Seizures, severe dysrhythmias, or decreasing level of consciousness indicating severe toxicity. Starting a sodium-restricted diet or a new diuretic without provider awareness.
What do I need to know about Lithium for the NCLEX?
The therapeutic serum level is narrow (about 0.6-1.2 mEq/L); levels above 1.5 mEq/L are toxic. Sodium and fluid balance directly affect lithium levels: low sodium, dehydration, or diuretics raise lithium and cause toxicity. Early toxicity signs include nausea, vomiting, diarrhea, fine tremor, and thirst. Worsening toxicity causes coarse tremor, confusion, ataxia, slurred speech, seizures, and cardiac dysrhythmias.
What patient teaching is important for Lithium?
Maintain a steady salt intake and drink plenty of water; do not crash diet or restrict salt. Report vomiting, diarrhea, or excessive sweating because they can cause toxicity. Keep all blood-level appointments and learn the early signs of toxicity such as tremor and confusion.
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Quick Tip
The therapeutic serum level is narrow (about 0.6-1.2 mEq/L); levels above 1.5 mEq/L are toxic.