Which instruction is correct for a client receiving lithium carbonate for bipolar disorder?

  1. breastfeeding may be done
  2. driving or using machinery is acceptable
  3. drugs containing ibuprofen should be avoided
  4. fluid intake should be limited to eight 8-oz glasses per day
Number 3 is correct.
Rationale: Ibuprofen will alter the effect of lithium and should be avoided. Breastfeeding is not recommended as lithium passes into breast milk and may have undesirable effects on a nursing infant. Driving, using machinery, or performing any activity that requires alertness or clear vision should be avoided until the patient is sure she can perform such activities safely. The patient should also drink extra fluids to prevent dehydration, a common side effect of taking lithium.