Overview
Introduction
A patient can become lithium toxic while taking every prescribed dose.
A patient can become lithium-toxic while taking every prescribed dose. Diarrhea, fever, poor intake, a new NSAID, or declining renal function may reduce lithium clearance enough to cause poisoning. The nurse's most useful early distinction is not the number alone: a new coarse tremor, ataxia, confusion, or myoclonus is a neurologic warning that requires action, even when the reported concentration is near the usual range. Lithium toxicity is managed as a clinical syndrome supported by serial laboratory data. Withhold the drug when toxicity is suspected, restore circulating volume, identify the cause of reduced clearance, and escalate promptly when neurologic, cardiac, or renal findings are severe.