Public Health and Waterborne Microbiology
Q: Name two waterborne diseases common in developing countries
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Coarse tremor, along with nausea, vomiting, diarrhea, and drowsiness, indicates lithium toxicity requiring immediate intervention. Lithium has narrow therapeutic index (0.6-1.2 mEq/L). Toxicity levels: mild (1.5-2.0 mEq/L) - GI symptoms, fine tremor, mild drowsiness; moderate (2.0-2.5 mEq/L) - coarse tremor, confusion, ataxia, slurred speech; severe (>2.5 mEq/L) - seizures, coma, renal failure, death. Factors increasing toxicity: dehydration, sodium restriction, NSAIDs, diuretics, renal impairment. Nursing actions for toxicity: hold lithium; check level; hydrate; monitor vital signs/ECG; prepare for dialysis if severe. Prevention: educate about maintaining fluid/salt intake; recognizing early signs; regular blood tests; and avoiding OTC medications without consultation. Lithium requires careful monitoring but is effective for bipolar disorder maintenance. Nurses teach patients to carry lithium alert card and not stop abruptly. Regular monitoring includes lithium levels, renal function, thyroid function, and ECG if indicated.
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