A nurse is teaching a client about benztropine to treat their Parkinson's disease symptoms. The nurse should instruct the client to report which of the following adverse effects?

A. Strawberry yogurt: During exacerbations, clients are advised a low-residue, low-fiber diet to reduce bowel stimulation. Strawberry yogurt may contain seeds and fruit pieces that increase mechanical irritation of the intestinal mucosa. Some clients with inflammatory bowel disease experience secondary lactose intolerance, which can worsen diarrhea and cramping.

B. Tossed spinach salad: Raw vegetables such as spinach are high in insoluble fiber, which increases stool bulk and intestinal motility. In Crohn’s disease, especially during active inflammation, high-fiber foods can exacerbate abdominal pain, diarrhea, and cramping. Raw leafy greens may also be difficult to digest when the intestinal mucosa is inflamed.

C. Buttered popcorn: Popcorn is high in insoluble fiber and contains hulls that are poorly digested. These can irritate inflamed intestinal tissue and increase peristalsis, potentially worsening symptoms such as diarrhea and abdominal discomfort. High-residue foods are generally avoided during flare-ups of Crohn’s disease.

D. Grilled chicken: Lean protein sources such as grilled chicken are recommended because they are low in fiber and easier to digest. Adequate protein intake supports tissue repair and helps prevent malnutrition, which is common in Crohn’s disease due to inflammation and decreased intake. Prepared without heavy seasoning or frying, grilled chicken aligns with a low-residue dietary approach.

A. Tachycardia: Increased intracranial pressure (ICP) typically triggers a Cushing’s response, which involves bradycardia rather than tachycardia. Tachycardia is more commonly associated with pain, fever, or hypovolemia and does not reliably indicate elevated ICP.

B. Hypotension: ICP elevation often leads to a compensatory increase in systemic blood pressure to maintain cerebral perfusion (Cushing’s triad: hypertension, bradycardia, irregular respirations). Hypotension is not a typical early sign of increased ICP and may indicate other complications such as shock.

C. Restlessness: Restlessness, agitation, or decreased level of consciousness is an early neurologic sign of increasing ICP. As pressure builds, cerebral perfusion decreases, leading to subtle behavioral changes, confusion, and irritability before more overt vital sign alterations occur. Early recognition allows timely intervention to prevent further neurologic compromise.

D. Amnesia: Amnesia may occur after traumatic brain injury due to direct neuronal injury or diffuse axonal injury. While it indicates neurologic involvement, it is not a specific or early indicator of elevated ICP. Monitoring for changes in mental status, behavior, and neurologic function is more sensitive for ICP assessment.