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Role of nurses in the initiation and the monitoring of Lithium

Published online by Cambridge University Press:  01 September 2022

M. Moalla ,
A. Larnaout ,
D. Skhiri ,
R. Lansari ,
N. Staali  and
W. Melki
M. Moalla*
Affiliation:
Razi Hospital, Psychiatry D, Manouba, Tunisia
A. Larnaout
Affiliation:
Razi Hospital, Psychiatry D, Manouba, Tunisia
D. Skhiri
Affiliation:
Razi Hospital, Psychiatry D, Manouba, Tunisia
R. Lansari
Affiliation:
Razi Hospital, Psychiatry D, Manouba, Tunisia
N. Staali
Affiliation:
Razi Hospital, Psychiatry D, Manouba, Tunisia
W. Melki
Affiliation:
Razi Hospital, Psychiatry D, Manouba, Tunisia
*
*Corresponding author.

Abstract

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Introduction

Lithium is the oldest known treatment of bipolar disorders and remains the gold standard. Nevertheless, it remains difficult to handle, largely due to its narrow therapeutic index and its long-term side effects. Thus, it requires special initiation and monitoring measures.

Objectives

This study aims to assess nurses’ knowledge and attitudes regarding lithium. A protocol on Lithium initiation and monitoring will be established.

Methods

This is a descriptive study including 20 nurses in a psychiatry department conducted from January to May 2021 based on an self-assessment questionnaire that was established to assess nurses’ knowledge about Lithium, its side effects, initiation and monitoring.

Results

None of the recruited nurses had any training regarding the use of lithium. The vast majority of subject (85%) said that lithium’s dosage must be individualized and adaptable to each patient throughout a specific blood test. 90% recognized renal failure as the most common contraindication of lithium. Complete Blood Count (CBC), and renal check-up were the only tests recognized as necessary by all the sample subjects. 90% answered that lithium is toxic and 65% answered that it is fatal. In case of toxicity by lithium all subjects (100%) agreed to call the responsible doctor of the patient, 25% of them chose it as a unique measure and 75% thought it was necessary to stop the lithium immediately as well.

Conclusions

Lithium is considered as a double-edged sword largely due to its narrow therapeutic index. Nevertheless, nurses are undertrained when it comes to its use and manipulation.

Disclosure

No significant relationships.

Keywords

monitoringNursesinitiationLithium
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S177 - S178
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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