A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?

A. The client takes 2 short naps during the day: The ability to sleep, even in short intervals, indicates a reduction in manic hyperactivity and an improvement in the client’s overall rest and circadian regulation.

B. The client appears to listen to unseen others: Persisting auditory hallucinations indicate ongoing psychotic symptoms, reflecting no improvement in the client’s mental status.

C. The client consumes 8 oz of high-calorie fluids each hour: Increased oral intake demonstrates improved self-care, nutritional status, and ability to participate in treatment, reflecting stabilization from prior neglect of eating.

D. The client slept 5 hr the previous night: Extended nighttime sleep suggests reduction of manic agitation and improved ability to rest, an important marker of therapeutic response to lithium and environmental management.

E. The client engages in quiet activities in their room: Participation in solitary, low-stimulation activities indicates decreased impulsivity and hyperactivity, demonstrating improved focus and emotional regulation.

A. Increased urinary frequency: Sertraline, a selective serotonin reuptake inhibitor (SSRI), is not commonly associated with increased urinary frequency. Urinary changes are more often related to other medication classes, such as diuretics or alpha-blockers.

B. Excessive sweating: Hyperhidrosis, or excessive sweating, is a known adverse effect of SSRIs, including sertraline. It occurs due to increased serotonergic activity affecting thermoregulatory centers and can be bothersome enough to require dose adjustment or symptomatic management.

C. Metallic taste in mouth: A metallic taste is more commonly reported with certain antibiotics or chemotherapy agents rather than SSRIs like sertraline. It is not a typical adverse effect of this medication.

D. Dry cough: Dry cough is not a recognized adverse effect of sertraline. Respiratory symptoms are uncommon with SSRIs and should prompt evaluation for other causes.