A nurse is assessing a client who is receiving a dose of IV amphotericin B. Which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?

A. Bruxism: Bruxism, or teeth grinding, is a potential adverse effect of citalopram but is generally less severe than confusion. While it should be monitored and reported if severe or persistent, it is not typically considered a priority adverse effect.
B. Confusion: Confusion can indicate a serious adverse reaction or complication, such as serotonin syndrome, which is a potentially life-threatening condition associated with the use of selective serotonin reuptake inhibitors (SSRIs) like citalopram. Therefore, confusion is the priority adverse effect to report to the provider.
C. Insomnia: Insomnia is a common side effect of citalopram and other SSRIs but is generally less severe than confusion. It should be monitored and reported if severe or persistent, but it is not typically considered a priority adverse effect.
D. Weight loss: Weight loss can occur as a side effect of citalopram but is generally less severe than confusion. It should be monitored and reported if excessive or rapid, but it is not typically considered a priority adverse effect.

A. Hyperactive bowel sounds: Muscarinic agonist poisoning typically results in increased gastrointestinal motility and hyperactive bowel sounds. Atropine, an anticholinergic medication, works by blocking muscarinic receptors and reducing gastrointestinal motility. Therefore, the presence of hyperactive bowel sounds may indicate ongoing muscarinic stimulation and inadequate treatment with atropine.
B. Heart rate 90/min: Atropine is an anticholinergic medication that increases heart rate by blocking the parasympathetic effects of acetylcholine on the heart. Bradycardia is a common manifestation of muscarinic agonist poisoning, and an increase in heart rate following atropine administration indicates reversal of this effect and effective treatment.
C. Blood pressure 90/50 mm Hg: Atropine administration may result in transient hypertension due to its effect on increasing heart rate and cardiac output. Hypotension is a common
manifestation of muscarinic agonist poisoning, and an increase in blood pressure following atropine administration may indicate improvement in cardiovascular function. Therefore, a blood pressure of 90/50 mm Hg may not necessarily indicate effective treatment with atropine.
D. Increased salivation: Muscarinic agonist poisoning typically results in excessive salivation (sialorrhea) due to stimulation of muscarinic receptors in the salivary glands. Atropine administration works by blocking these muscarinic receptors and reducing salivation. Therefore, increased salivation would indicate ongoing muscarinic stimulation and inadequate treatment with atropine.