What is a sign of lithium toxicity that the nurse should monitor for in a client with bipolar disorder?

An unsteady gait is indeed a sign of lithium toxicity that should be monitored in patients with bipolar disorder. Lithium, a mood stabilizer used to treat manic episodes and maintenance therapy in bipolar disorder, has a narrow therapeutic range. Toxicity can occur when plasma levels exceed this range, leading to neurological symptoms among others.

An unsteady gait may indicate neurological impairment resulting from elevated lithium levels, as lithium can affect motor control and coordination. This symptom can be part of a wider clinical picture that includes confusion, tremors, and ataxia, emphasizing the need for close monitoring of patients receiving lithium therapy.

In contrast, the other options represent outcomes that are not typically associated with lithium toxicity. Dry skin may occur due to various factors, increased appetite is not a usual side effect of lithium toxicity, and headaches, while they can happen during treatment, are not specific indicators of lithium overdose. Monitoring for an unsteady gait is therefore critical in the management of patients receiving lithium to prevent serious complications associated with toxicity.