A nurse on an inpatient mental health unit is caring for a client diagnosed with major depressive disorder and malnutrition. Which of the following actions should the nurse take to improve the client's nutritional status?

Choice A reason:
Increased heart rate is not typically a sign of opioid overdose. Opioid overdose often leads to a decrease in the body's autonomic responses, which can cause a slowing of the heart rate rather than an increase.

Choice B reason:
Slow, shallow breathing is a hallmark sign of opioid overdose. Opioids can depress the central nervous system, leading to respiratory depression. This is a critical symptom and requires immediate medical attention¹²³⁴.

Choice C reason:
Constricted pupils, also known as pinpoint pupils, are another classic sign of opioid overdose. This occurs due to the action of opioids on the part of the brain that regulates the size of the pupils¹²³⁴.

Choice D reason:
Increased motor activity is generally not associated with opioid overdose. Instead, opioids tend to cause a decrease in motor activity, leading to lethargy and a lack of coordination.

Choice A reason:
A necklace can pose a risk for clients with suicidal tendencies as it can be used to inflict self-harm. In an acute mental health unit, it is crucial to remove any items that could potentially be used in another suicide attempt. The nurse should ensure that the environment is safe and free from objects that could be used for hanging or strangulation.

Choice B reason:
Lace-up tennis shoes have laces that can be removed and used by the client to harm themselves. It is a standard safety precaution in mental health units to remove any items with strings or laces, such as belts, drawstrings, or shoe laces, to prevent their use in self-harm or suicide attempts.

Choice C reason:
Nylon ankle socks are generally considered safe and do not typically need to be removed. They do not pose a significant risk for self-harm. Therefore, the client can keep these for personal comfort and hygiene.

Choice D reason:
Cotton underwear is a basic necessity and does not present a risk for self-harm. It is important for the client's dignity and hygiene to have access to personal undergarments while in the mental health unit.

Choice E reason:
A glass-framed picture, while sentimental, poses a risk due to the glass, which can be broken and used to inflict self-harm. For safety reasons, any items made of glass or other breakable materials should be removed from the client's access in a mental health unit.