"Mаle аnd femаle bоth must tend the hearth and bоth must venture fоrth"
A 29-yeаr-оld wоmаn with histоry of bipolаr disorder is brought to the emergency department by ambulance after her wife called 911. The patient’s wife reports that the patient injured her back at work lifting heavy boxes 1 week ago. Starting 3 days ago, the patient developed nausea, vomiting, and diarrhea and called out sick from work. The patient’s wife is not sure what medications she has been taking. She attributed this to being around her sick niece over the weekend who had similar symptoms, but this morning, patient’s wife reports that she was confused and didn’t know where she was. On mental status exam, the patient is found to be lethargic, oriented only to self and year, and she is unable to spell WORLD backwards. Physical exam is notable for course tremor and ataxia. Laboratory findings are significant for creatinine of 3/0 mg/dl and serum lithium level of 2.7 mmol/L. Which of the following treatments is the most appropriate next step in the management of this patient?