A mental health nurse is providing preventive care for a group of clients in the community. Which of the following actions by the nurse demonstrates a secondary prevention strategy?

A. Weight gain and dry mouth: Weight gain and dry mouth are common adverse effects of lithium at therapeutic levels. They are not immediately dangerous but can affect compliance with the medication regimen.

B. Oliguria (reduced urine output) and muscle weakness are more concerning symptoms. They can indicate potential toxicity, especially oliguria, which suggests possible renal impairment, a serious concern with lithium therapy.

C. Hallucinations and blurred vision are more severe and typically associated with lithium toxicity rather than therapeutic levels. They indicate a need for immediate medical attention.

D. Coarse hand tremors and confusion: Coarse hand tremors and confusion are signs of lithium toxicity. At therapeutic levels, fine hand tremors can occur, but coarse tremors and confusion suggest higher serum levels.These symptoms are associated with toxicity and require urgent medical evaluation.

A. A client who has new-onset delirium: Delirium is characterized by acute confusion and changes in cognition, often due to underlying medical conditions. Assertiveness training may not be appropriate for someone experiencing delirium, as their cognitive impairment may interfere with their ability to participate effectively in the therapy session.

B. A client who is experiencing auditory hallucinations: Auditory hallucinations involve perceiving sounds or voices that are not actually present. Assertiveness training may not directly address the underlying cause of auditory hallucinations, which typically require other therapeutic approaches such as medication management and cognitive-behavioral therapy.

C. A client who is experiencing mania: Mania is a state of elevated mood, increased energy, and often impulsivity. While assertiveness training could potentially be beneficial for individuals with bipolar disorder during periods of stability, it may not be appropriate during acute manic episodes when the client's judgment and insight may be impaired.

D. A client who has somatic symptom disorder: Somatic symptom disorder involves experiencing distressing physical symptoms that are disproportionate to any identified medical condition. Assertiveness training could be helpful for individuals with somatic symptom disorder to effectively communicate their concerns with healthcare providers and advocate for appropriate care.