A nurse is caring for a client who has depression and states, "A government agency is attempting to capture me." The nurse should identify that the client is experiencing which of the following?

A. "Lip smacking and tongue thrusting." These symptoms are more characteristic of tardive dyskinesia, a side effect of long-term antipsychotic use, rather than lithium toxicity. Lithium toxicity primarily affects the gastrointestinal and neurological systems. While movement disorders can occur with severe toxicity, lip smacking and tongue thrusting are not typical early signs.
B. "GI discomfort and poor coordination." A lithium level of 1.6 mEq/L falls within the mild to moderate toxicity range. Early signs include nausea, vomiting, diarrhea, and fine hand tremors. Poor coordination, dizziness, and muscle weakness may also be present as lithium begins affecting the central nervous system. Prompt intervention, such as fluid management and dose adjustment, is necessary to prevent progression to severe toxicity.
C. "Blurred vision and jerking motor movements." Severe lithium toxicity (levels above 2.0 mEq/L) can cause neurological impairments, including tremors, muscle rigidity, and seizures. However, at a level of 1.6 mEq/L, symptoms are generally milder and include gastrointestinal distress and coordination issues. Blurred vision and significant motor dysfunction are more indicative of advanced toxicity.
D. "Fever and fluctuating blood pressure." Autonomic instability, including fever and blood pressure fluctuations, is not a common manifestation of lithium toxicity. These symptoms are more characteristic of conditions such as serotonin syndrome or neuroleptic malignant syndrome. Lithium toxicity primarily presents with gastrointestinal, neurological, and coordination-related symptoms.

A. School-age: Schizophrenia is rare in children, and early-onset cases before adolescence are uncommon. Symptoms that resemble schizophrenia in children often require further evaluation for other neurodevelopmental disorders.
B. Young adulthood: Schizophrenia typically manifests between late adolescence and early adulthood, usually between ages 18 and 25 in men and slightly later in women. This period is when individuals experience their first psychotic episode.
C. Preschooler: Schizophrenia is extremely rare in preschool-aged children. Symptoms such as hallucinations or disorganized behavior at this age are more likely related to other developmental disorders or trauma.
D. Older adulthood: Late-onset schizophrenia is rare, and when psychotic symptoms emerge in older adults, they are often due to conditions such as dementia, delirium, or medication effects rather than primary schizophrenia.