A 78-year-old patient with a history of hypertension and diabetes is admitted to the hospital with symptoms of confusion, agitation, and hallucinations. Which of the following nursing interventions are appropriate in this scenario? (Select all that apply)

Choice A reason: Five tablets (250 mg) exceed the prescribed 150 mg, risking Sertraline overdose. This SSRI increases serotonin, and excessive dosing may cause serotonin syndrome, with symptoms like agitation or seizures. Scientifically, precise dosing prevents adverse neurological effects, ensuring safe treatment for depression or anxiety.

Choice B reason: Four tablets (200 mg) overdose the patient, exceeding the 150 mg prescription. Sertraline’s serotonin-enhancing effects can lead to toxicity, causing symptoms like nausea or tremors. Scientifically, overdosing disrupts neurotransmitter balance, risking serious side effects, while correct dosing ensures effective mood stabilization without harm.

Choice C reason: Three tablets (150 mg) match the prescribed dose, ensuring therapeutic serotonin levels. Scientifically, accurate Sertraline dosing optimizes neurotransmitter balance, effectively treating depression or anxiety by enhancing serotonin activity in the prefrontal cortex and amygdala, reducing symptoms without risking toxicity or side effects.

Choice D reason: Two tablets (100 mg) underdose the patient, providing insufficient serotonin modulation. Scientifically, subtherapeutic Sertraline levels fail to address neural imbalances in depression or anxiety, risking persistent low mood or panic symptoms, as inadequate dosing doesn’t sufficiently enhance neurotransmitter activity for effective treatment.

Choice A reason: Stress management techniques, like mindfulness, reduce relapse risk by calming amygdala-driven stress responses. Scientifically, these strategies lower cortisol and stabilize dopamine pathways, addressing addiction’s neurobiological triggers. This empowers the client to manage stress, enhancing emotional regulation and supporting sustained recovery from substance use disorder.

Choice B reason: Avoiding stress entirely is unrealistic, as addiction recovery involves facing triggers. Scientifically, avoidance may reinforce fear-based neural pathways, increasing cortisol and relapse risk. Structured coping strategies are needed to modulate stress responses, ensuring resilience and preventing neurobiological destabilization in substance use recovery.

Choice C reason: Referral to a specialist is premature without assessing coping needs. Stress in addiction stems from dopamine dysregulation and environmental triggers. Scientifically, immediate coping strategies address acute stress responses, while referral may delay stabilization, risking relapse by not targeting the client’s current neurobiological stress profile.

Choice D reason: Increasing medication dosage without assessment risks dependency or side effects. Stress in addiction involves complex neural pathways, like dopamine and cortisol. Scientifically, unguided dose increases may disrupt neurotransmitter balance, exacerbating addiction vulnerabilities and delaying effective stress management through tailored psychological interventions.