Chapter 17 – Nothing Physical

A typical clinical day [on a mental health unit] started at 8:00 a.m., listening to the PM and night taped reports with just our student group. Jonas Berzinsky is in for depression. He’s on EPs and SPs. Using the pause button, I asked questions: “What are EPs?” Elopement precautions. “What are SPs?” Suicide precautions. The doctor may start him on Lithium today. Pause button. “What is Lithium usually given for?” Bipolar disorder. “Why would this patient be going on Lithium?” Maybe depression was the admitting diagnosis, but we’ll find symptoms of mania or hypomania documented on the chart. “What is the normal therapeutic range of Lithium?” Around 1 mEq per liter. Point 6 to 1.4. (They’d put up their index finger like I had showed them in class to remember the “one” when taking state boards. This blood level was sure to be a question.) “What are side effects?” Fine hand tremor, polyuria, polydipsia.

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