Conceptualization of lab values and comprehensive plan

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Reference no: EM133925539

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You are working with a 67-year-old male for a follow-up visit. You have been working together for the last 15 years on management of bipolar I disorder. The patient has not had any manic episodes since last hospitalized 14 years ago, at which time lithium carbonate was started. The patient has not had any depressive episodes for the last 10 years. The patient is consistently adherent to medications and has a strong support system. Prior to initiation of lithium, the patient had failed trials of Depakote (valproate), Tegretol (carbamazepine), and Zyprexa (olanzapine). This patient has developed hypothyroidism and is on supplemental Synthroid (levothyroxine). He is also on lisinopril 10mg PO daily for HTN management and Lipitor 20mg PO daily for lipid management. He takes lithium carbonate 900mg PO QHS. He sees his primary care provider every 6-12 months. Here are the patient's most recent lab values that you ordered: Lithium level (trough): 0.9 TSH: 1.45 BUN/creat: 18 / 1.0 GFR: 88 (decrease since last checked 6 months ago) EKG: Normal sinus rhythm with T wave inversion (unchanged from previous EKG done 1 year ago) Discuss your conceptualization of the lab values and a comprehensive plan to address any concerns that.

Reference no: EM133925539

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