A nurse is caring for a client who has bulimia nervosa has a new prescription for a selective serotonin reuptake inhibitor (SSRI). Which of the following medications should the nurse anticipate administering?

A. Extrapyramidal symptoms. Extrapyramidal symptoms (EPS) include acute dystonia, akathisia, and parkinsonism, which are movement-related side effects caused by dopamine blockade. While EPS can involve muscle rigidity and tremors, tardive dyskinesia specifically refers to chronic, involuntary, repetitive movements such as facial twitching and tongue protrusion.
B. Impaired ability to regulate body temperature. Some antipsychotics can interfere with thermoregulation, leading to heat intolerance or hypothermia. However, this is not related to jerking or twitching movements seen in tardive dyskinesia.
C. Neuroleptic malignant syndrome. Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Unlike tardive dyskinesia, NMS does not cause chronic, involuntary facial movements but rather widespread muscle stiffness and severe autonomic dysfunction.
D. Tardive dyskinesia. Tardive dyskinesia (TD) is a late-onset, irreversible movement disorder caused by long-term use of first-generation antipsychotics. It is characterized by involuntary, repetitive movements, especially in the face, tongue, and extremities (e.g., lip smacking, tongue rolling, grimacing, jerking movements). These symptoms distinguish TD from acute extrapyramidal symptoms.

A. Identification phase. In this phase, the nurse and client begin to build a therapeutic relationship and establish trust. The focus is on identifying the client's needs and concerns rather than actively engaging in therapeutic interventions like guided therapy.
B. Exploitation phase. During the exploitation phase, the nurse encourages the client to utilize the resources and therapeutic interventions available to them. This is an appropriate time to suggest guided therapy sessions, as the client is actively engaged in exploring their issues and working toward improvement.
C. Resolution phase. The resolution phase involves evaluating the progress made and preparing for the termination of the nurse-client relationship. It is not the appropriate time to introduce new therapeutic modalities, as the focus shifts to consolidating gains and planning for future support.
D. Orientation phase. The orientation phase establishes the groundwork for the therapeutic relationship, including discussing goals and expectations. While important, it is not the phase where guided therapy sessions would typically be suggested, as the relationship is still in its initial stages.