A nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching?

Choice A rationale:

The client’s reported behavior of using laxatives and inducing vomiting after eating can lead to a condition known as hypomagnesemia. Hypomagnesemia is a condition characterized by low levels of magnesium in the blood. This condition can be caused by poor intake, excessive loss, or movement of magnesium from the blood into less accessible locations. The use of laxatives can lead to excessive loss of magnesium through increased bowel movements. Similarly, self-induced vomiting can also result in a loss of magnesium. Therefore, the client’s behavior puts them at risk for developing hypomagnesemia.

Choice B rationale:

Renal failure, also known as kidney failure, occurs when the kidneys lose their ability to filter waste products from the blood. While the use of laxatives and self-induced vomiting can lead to dehydration, which can strain the kidneys, these behaviors are not directly associated with renal failure. Therefore, while it’s possible for the client to develop kidney problems, it’s less likely compared to hypomagnesemia.

Choice C rationale:

Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. This condition can cause symptoms like shortness of breath, swelling, fatigue, and other symptoms. While severe electrolyte imbalances, such as those that might result from the use of laxatives and self-induced vomiting, can affect heart function, they would typically result in arrhythmias (irregular heartbeats) rather than heart failure. Therefore, it’s less likely for the client to develop heart failure based on the behaviors described.

Choice D rationale:

Hyperthyroidism is a condition where the thyroid gland produces and releases too much thyroid hormone. This condition can cause symptoms like rapid heartbeat, weight loss, and anxiety. The client’s behaviors of using laxatives and inducing vomiting after eating do not directly influence the production of thyroid hormones. Therefore, it’s less likely for the client to develop hyperthyroidism based on the behaviors described.

Choice A rationale: Clients who are admitted involuntarily cannot be hospitalized for as long as the provider deems necessary. There are legal and ethical guidelines that dictate the length and conditions of involuntary hospitalization. These guidelines vary by jurisdiction, but they generally require periodic review and reevaluation of the client’s condition and the necessity of continued hospitalization.

Choice B rationale: Clients cannot be given medications against their will under normal circumstances. Informed consent is a fundamental right in healthcare, including mental health care. This means that clients have the right to be fully informed about the potential benefits, risks, and alternatives of a proposed treatment, and to make an informed decision about whether to accept or refuse the treatment. There are exceptions in emergency situations where the client poses an immediate danger to self or others, but these are governed by strict legal and ethical guidelines.

Choice C rationale: Clients who are involuntarily admitted do have the right to informed consent. This means that even if a client is admitted to a mental health facility against their will, they still have the right to be informed about their treatment and to make decisions about their care. This includes the right to be informed about the potential benefits, risks, and alternatives of proposed treatments, and the right to refuse treatment.

Choice D rationale: The laws regarding restraints are not different for clients who are admitted involuntarily. Restraints can only be used as a last resort when less restrictive interventions have failed and the client poses an immediate danger to self or others. The use of restraints is governed by strict legal and ethical guidelines, and these apply to all clients, regardless of whether they were admitted voluntarily or involuntarily.