A client comes to the clinic exhibiting symptoms of agitation, sweating, confusion, hyperreflexia, tachycardia, and ataxia the day after starting a new prescription for citalopram. What syndrome does the nurse suspect is occurring?

VATI Mental Health Remediation NR452

1. A client comes to the clinic exhibiting symptoms of agitation, sweating, confusion, hyperreflexia, tachycardia, and ataxia the day after starting a new prescription for citalopram. What syndrome does the nurse suspect is occurring?
   • Answer: The nurse suspects Serotonin Syndrome. These symptoms—agitation, sweating, confusion, hyperreflexia, tachycardia, and ataxia—are characteristic of Serotonin Syndrome, a potentially life-threatening condition that can occur when a client starts taking a serotonergic drug like citalopram.
2. What should a client’s lithium level be during the initial treatment of a manic episode? What is the maintenance level range for this medication therapy? At what plasma levels could toxicity occur?
   • Answer:
     • Initial Treatment: During the initial treatment of a manic episode, the lithium level should be between 1.0 mEq/L and 1.5 mEq/L.
     • Maintenance Therapy: For maintenance therapy, the lithium level should be between 0.6 mEq/L and 1.2 mEq/L.
     • Toxicity: Lithium toxicity can occur at levels above 1.5 mEq/L, with severe toxicity typically occurring at levels above 2.0 mEq/L. Symptoms of toxicity may include nausea, vomiting, diarrhea, tremors, confusion, seizures, and in severe cases, coma.
3. A nurse is caring for a client experiencing opioid withdrawal. List three (3) manifestations the client will display during withdrawal.
   • Answer:
     • Physical Symptoms: The client may experience flu-like symptoms such as fever, sweating, and shaking.
     • Psychological Symptoms: The client may exhibit anxiety, restlessness, and irritability.
     • Behavioral Symptoms: The client may display drug-seeking behaviors, such as a strong craving for opioids and difficulty focusing on tasks.