A nurse is reinforcing teaching with a client who is scheduled for implantation of a vagus nerve stimulator. Which of the following statements should the nurse include in the teaching?

Choice A reason: Weight gain is a common manifestation after cessation of nicotine use. Nicotine is an appetite suppressant, and its absence can lead to increased appetite and caloric intake. Additionally, some individuals may turn to food as a substitute for smoking, leading to weight gain. Understanding this can help in planning strategies to manage weight during the cessation process.

Choice B reason: Difficulty concentrating is another common symptom experienced during nicotine withdrawal. Nicotine has stimulant effects on the brain, enhancing concentration and alertness. When a person stops using nicotine, they may experience cognitive difficulties, including trouble focusing and memory issues. These symptoms are typically temporary but can be challenging during the withdrawal period.

Choice C reason: Diarrhea is not a common manifestation of nicotine cessation. Gastrointestinal symptoms like constipation are more frequently reported during nicotine withdrawal. The body's digestive system adjusts to the absence of nicotine, which can result in changes in bowel habits, but diarrhea is less typical.

Choice D reason: Restlessness is a well-documented symptom of nicotine withdrawal. The body and mind are accustomed to the stimulant effects of nicotine, and its absence can lead to increased agitation and restlessness. This symptom can contribute to the difficulty of quitting smoking, as it creates a sense of discomfort and unease.

Choice E reason: Decreased appetite is not typically associated with nicotine cessation. Instead, increased appetite is more commonly observed due to the removal of nicotine's appetite-suppressing effects. Therefore, decreased appetite is not a typical manifestation of nicotine withdrawal.

Choice A reason: Systematic desensitization is a technique primarily used for anxiety disorders and phobias, rather than for preventing relapse in depression. This method involves gradually exposing a person to anxiety-provoking stimuli while teaching them relaxation techniques to cope with the anxiety. While it is an effective therapeutic tool, it is not specifically aimed at preventing relapse in depression. Instead, it is more suitable for conditions where anxiety and avoidance behaviors are predominant issues.

Choice B reason: Antidepressant medications typically take several weeks to begin showing their full therapeutic effects, not just a few days. Telling a client that they will feel better in a few days can lead to unrealistic expectations and potential disappointment if the medication does not work immediately. Clients should be informed that it might take a few weeks to notice significant improvements and that they should continue taking the medication as prescribed and follow up with their healthcare provider.

Choice C reason: Identifying how one reacts to stressful events is crucial in managing depression and preventing relapse. Stressful events can trigger or exacerbate depressive episodes. By understanding their responses to stress, clients can develop coping strategies and seek appropriate support when needed. This proactive approach helps in recognizing early signs of relapse and implementing measures to mitigate the impact of stress on their mental health. Therefore, this advice is practical and directly applicable to preventing depression relapse.

Choice D reason: Snapping a rubber band on the wrist as a way to interrupt depressive thoughts is a behavioral technique that might work for some individuals in the short term. However, it is not a comprehensive strategy for preventing depression relapse. This method is more of a distraction technique and does not address the underlying issues or equip the client with long-term coping strategies. Effective relapse prevention in depression involves a more holistic approach, including cognitive-behavioral techniques, medication adherence, and lifestyle changes.