---
title: Lithium monitoring follow-up Note Template & Example | Nextvisit
description: Lithium follow-up with serum trend, renal and thyroid labs, side effects, and dose-adjustment rationale.
url: "https://nextvisit.ai/templates/lithium-monitoring"
type: static
generatedAt: "2026-09-21T03:14:00.672Z"
---

Note template
# Lithium monitoring follow-up Note Template & Example

Lithium follow-up with serum trend, renal and thyroid labs, side effects, and dose-adjustment rationale.

Updated May 7, 2026

Long-term lithium needs more than a generic med-management note. Serum levels trend. Creatinine, eGFR, and TSH need periodic review. Tremor, polyuria, weight, and cognitive blunting shift visit to visit. The dose decision is the trend, not a single number.

Built for psychiatrists and psychiatric NPs following bipolar patients on lithium. Level history, lab interval, and side-effect trajectory have their own fields. Fits a 20-minute stable check and a longer visit when a level is out of range. The Lithium tag keeps the panel filterable for lab-cycle management.

```
Patient: [patient_name]    DOB: [dob]    Age: [age]
Date: [encounter_date]     Provider: [provider_name]    Duration: [duration]
Diagnosis: [icd10] (bipolar I, bipolar II, schizoaffective, augmentation for MDD)
Lithium formulation and dose: immediate-release / extended-release, total daily dose
Years on lithium: [years_on_lithium]

Subjective
- Mood interval (euthymic, depressive, hypomanic, mixed):
- Sleep, energy, concentration, racing thoughts:
- Adherence (missed doses, timing, with food):
- Lithium side effects:
  - Tremor (fine, coarse, functional impact):
  - Polyuria, polydipsia, nocturia:
  - Weight change:
  - GI symptoms (nausea, diarrhea):
  - Cognitive complaints (slowing, word-finding):
  - Cutaneous (acne, psoriasis):
  - Hypothyroid symptoms (cold intolerance, fatigue, weight gain):
- NSAID, ACE inhibitor, ARB, diuretic, dehydration, fever, low-sodium diet (interaction risks):
- Recent illness or hospitalization:
- Substance use:
- Pregnancy status if applicable:

Objective
- Vitals (BP, HR, weight):
- Mental status exam:
- Tremor exam if performed:
- Lithium level
  - Most recent: [level] mEq/L  Drawn: [draw_time]  Trough timing confirmed: yes / no
  - Trend across last four levels:
- Recent labs
  - Creatinine, BUN, eGFR (with trend):
  - TSH (with trend), free T4 if indicated:
  - Calcium (PTH if indicated):
  - CBC, electrolytes, urinalysis if indicated:
- Last ECG (if older patient or new cardiac symptom):

Risk assessment
- Suicidal ideation:
- Toxicity risk indicators (level approaching 1.2, dehydration, recent NSAID start):

Assessment
- Mood stability across interval:
- Lithium therapeutic range adequacy:
- Renal trajectory:
- Thyroid status:
- Side-effect tolerability:
- Diagnostic update if any:

Plan
- Lithium dose continued:
- Lithium dose adjustment (with rationale and target level):
- Next lithium level: [date]
- Next renal panel and TSH: [date]
- Other labs ordered:
- Concurrent medications continued or adjusted:
- Patient education (hydration, NSAIDs, sodium intake, illness sick-day rules):
- Coordination with PCP for renal and thyroid:
- Safety planning if relevant:
- Follow-up interval:
```

AriaMD pulls lithium, renal, and thyroid trends into the note so the dose decision references the trend. Side-effect language stays in its field. NSAID starts, new ACE inhibitors, and low-sodium diets get flagged when they come up. The Lithium tag keeps the panel filterable for quarterly lab-cycle review.

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