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John is a 41-year old-patient who presents to the clinic with diarrhea, fatigue, and recently has been having tremors. He was diagnosed 19 years ago with bipolar disorder and is currently managed on Lithium 300mg BID. As the PMHNP, you decide to order a lithium level that comes back at 2.3mmol/l. What is the most appropriate course of action?

a.

Investigate other differential diagnoses for his symptoms.

b.

Tell John to skip his next four Lithium doses and resume therapy.

c.

Tell John he needs to go to the hospital and call an ambulance to bring him.

d.

Prescribe loperamide to treat the diarrhea and ropinirole to treat the tremors

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