The nurse is reviewing a client's lithium level of 1.8 mEq/L. What should the nurse do?

When interpreting a lithium level of 1.8 mEq/L, it is important to recognize that this level is above the therapeutic range, which typically lies between 0.6 and 1.2 mEq/L. A level at 1.8 suggests that the client may be approaching toxicity, which can lead to adverse effects and serious complications.

In such a case, the appropriate nursing action is to hold the 5 pm dose of lithium. This decision helps prevent further elevation of the lithium level and reduces the risk of toxicity. Monitoring the client's symptoms and coordinating with the healthcare provider for further assessment or interventions would also be critical steps following this decision.

The other options would potentially exacerbate the situation. Administering the dose or timing it around meals does not address the immediate concern of elevated lithium levels. Ensuring the client remains safe from potential toxicity is paramount, which is why holding the dose is the most responsible and correct action in this scenario.