A nurse is assessing a client who is experiencing acute cocaine toxicity. Which of the following findings should the nurse expect?

A- Urinary frequency: Anxiety, particularly moderate to severe anxiety, can stimulate the sympathetic nervous system, which may lead to physical symptoms such as increased urination or urinary frequency. This is due to the body’s "fight-or-flight" response, which can affect the bladder.

B.Clients experiencing moderate anxiety may speak rapidly as their thoughts race, and they may feel an urgent need to express their concerns.

C- Chills: Chills are not typically associated with moderate anxiety disorder. Chills are more commonly seen in conditions such as infections or fever.

D- Distorted perceptual field: Distorted perceptual field, also known as perceptual disturbances, is not typically associated with moderate anxiety disorder. Perceptual disturbances refer to sensory experiences such as hallucinations or illusions, which are more commonly seen in severe mental health conditions like psychosis or substance-induced disorders.

In this scenario, a priority action for the nurse is to ask the client if she has considered harming her newborn. The client's symptoms of feeling "down," sadness, lack of energy, and wanting to cry raise concerns about the possibility of postpartum depression, which is a serious mental health condition that can affect new mothers. In some cases, postpartum depression can lead to thoughts of harming oneself or the newborn. Therefore, it is crucial for the nurse to assess the client's risk and ensure the safety of both the client and her baby.

Incorrect:

A- Reinforce postpartum and newborn care discharge teaching: While reinforcing postpartum and newborn care discharge teaching is an important aspect of care, it is not the priority in this situation. The client's symptoms of feeling "down," sadness, lack of energy, and wanting to cry suggest the possibility of postpartum depression. The nurse should prioritize addressing the client's emotional well-being and assessing for potential risks, rather than focusing on routine postpartum and newborn care teaching.

B- Anticipate a prescription by the provider for an antidepressant: While medication may be part of the treatment plan for postpartum depression, it is not the priority action at this stage. The nurse should first assess the client's condition, including the severity of her symptoms and any potential risk of harm to herself or her newborn. Initiating a discussion about medication can come later, in collaboration with the healthcare provider and based on a comprehensive assessment.

C- Assist the family to identify prior use of positive coping skills in family crises: While supporting the client's family and identifying positive coping skills are important, they are not the priority in this scenario. The immediate concern is addressing the client's symptoms and assessing for potential risks associated with postpartum depression. Once the client's immediate safety and emotional needs are addressed, the nurse can involve the family in the care plan and help them identify and utilize positive coping strategies.