A nurse is teaching the guardian of a newborn about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?

 

Choice A reason: Excessive sweating is a hallmark of serotonin syndrome, a life-threatening condition from serotonin excess, often with sertraline. It accompanies agitation, hyperthermia, and muscle rigidity, requiring immediate reporting to prevent complications like seizures or organ failure due to serotonin toxicity.

Choice B reason: Dry mouth is a common side effect of sertraline but not specific to serotonin syndrome. It results from anticholinergic effects, not serotonin excess, and does not require immediate reporting unless severe, making it an incorrect choice for urgent monitoring.

Choice C reason: Constipation is a side effect of sertraline due to slowed gastrointestinal motility but is not indicative of serotonin syndrome. It is manageable with lifestyle changes and does not signal a medical emergency, making it irrelevant for immediate reporting.

Choice D reason: Insomnia is a side effect of sertraline, often resolving with time, but not a symptom of serotonin syndrome. It does not indicate acute toxicity requiring urgent intervention, unlike sweating, which signals systemic serotonin overload, making this incorrect.

Choice A reason: Metformin extended-release tablets must not be crushed to maintain controlled drug release, ensuring steady blood glucose control. This understanding prevents dosing errors, critical for managing diabetes. Correct client knowledge supports adherence, reducing risks of hyperglycemia or gastrointestinal side effects, essential for effective long-term diabetes management.

Choice B reason: Metformin typically causes weight neutrality or loss, not gain, by improving insulin sensitivity. Expecting weight gain indicates misunderstanding, risking nonadherence if clients fear side effects. Correct teaching clarifies weight effects, ensuring compliance, critical for glycemic control and preventing complications in clients with diabetes on metformin therapy.

Choice C reason: Metformin extended-release is often taken at night to reduce morning hyperglycemia, not strictly in the morning, though timing varies. Assuming morning dosing risks suboptimal control. Correct teaching specifies provider-directed timing, ensuring efficacy, critical for managing blood glucose and preventing diabetic complications in clients on extended-release formulations.

Choice D reason: Metformin is taken with food to reduce gastrointestinal upset, not on an empty stomach. This statement shows misunderstanding, risking side effects like nausea, which could reduce adherence. Correct teaching emphasizes food co-administration, critical for client comfort and sustained compliance in managing diabetes with metformin therapy.