A 10-year-old child with ADHD has been prescribed a stimulant medication. The parent reports that the child has been eating less since starting the medication. What is the most appropriate nursing intervention to address this side effect?

A. Respiratory arrest and coma: These are late, life-threatening manifestations of local anesthetic systemic toxicity (LAST) that occur after CNS and cardiovascular collapse. Recognizing early signs is critical to preventing progression to this severe stage.
B. Ventricular arrhythmias and cardiac arrest: These are also late signs of LAST, resulting from the anesthetic’s depressant effects on cardiac conduction. By the time these occur, toxicity is advanced and may require immediate resuscitation measures.
C. Hypotension and tachycardia: Although cardiovascular symptoms may eventually develop, they are typically preceded by neurological signs. Early identification and management of CNS symptoms can often prevent progression to cardiovascular compromise.
D. Tinnitus, metallic taste, and perioral numbness: These are classic early signs of LAST and indicate CNS involvement. They often occur within minutes of administration and should prompt immediate intervention to stop drug absorption and initiate supportive care.

• Hypertension: Seen in anticholinergic toxicity due to decreased parasympathetic tone and possible unopposed sympathetic stimulation. The body's inability to relax vascular tone may contribute to elevated blood pressure.
• Urinary Retention: A classic feature of anticholinergic toxicity. Inhibition of muscarinic receptors leads to impaired detrusor muscle contraction, making urination difficult or impossible.
• Hyperthermia: Results from inhibited sweating (anhidrosis), which is a hallmark of anticholinergic toxicity. Without the ability to cool through evaporation, body temperature rises dangerously.
• Diaphoresis: Excessive sweating is mediated by muscarinic receptor activation in cholinergic toxicity. It's often part of the SLUDGE symptoms seen in organophosphate poisoning or cholinesterase inhibitor overdose.
• Bronchoconstriction: Caused by overstimulation of muscarinic receptors in the airways, leading to narrowed bronchi and increased respiratory secretions — a dangerous feature of cholinergic excess.
• Salivation: Prominent in cholinergic toxicity due to unopposed parasympathetic activation. It may occur along with lacrimation, bradycardia, and other signs of excessive cholinergic stimulation.