A nurse is caring for a client who has difficulty holding utensils while eating. The nurse should obtain a referral for which of the following members of the interprofessional team?

Choice A reason: Bronchodilators are used for conditions such as asthma or COPD to relieve bronchospasm. They are not routinely indicated for end-of-life dyspnea unless the client has a specific underlying respiratory condition. This option is incorrect because it does not address typical palliative care measures.

Choice B reason: Placing the client in Trendelenburg position (head lower than feet) worsens breathing difficulty by increasing pressure on the diaphragm and promoting aspiration risk. This option is incorrect because it would exacerbate respiratory distress.

Choice C reason: Using a fan to increase air circulation is a simple, non-invasive, and effective intervention for relieving dyspnea at the end of life. The sensation of moving air across the face can reduce the perception of breathlessness and improve comfort. This is the correct answer because it aligns with evidence-based palliative care practices.

Choice D reason: Decreasing oral fluid intake does not relieve dyspnea. While fluid restriction may be used in cases of fluid overload, it is not a direct intervention for easing breathing difficulty in end-of-life care. This option is incorrect because it does not address the client’s immediate symptom.

Choice A reason: Insomnia is a common adverse effect of desvenlafaxine, an SNRI antidepressant. By increasing serotonin and norepinephrine levels, the medication can cause heightened alertness and difficulty sleeping. This is a well-documented side effect and should be monitored.

Choice B reason: Weight loss is not a typical adverse effect of desvenlafaxine. While some antidepressants may affect appetite, desvenlafaxine is more likely to cause nausea or decreased appetite rather than significant weight loss.

Choice C reason: Diarrhea can occur with some antidepressants, but it is not a primary adverse effect of desvenlafaxine. Gastrointestinal upset is more commonly seen as nausea rather than persistent diarrhea.

Choice D reason: Increased salivation is not associated with desvenlafaxine. Antidepressants may cause dry mouth due to anticholinergic effects, but excessive salivation is not expected.