A nurse is caring for a client who has depression.

After two days of treatment, the nurse notices that the client is suddenly more active and there are no longer signs of a depressive state.

Which of the following interventions should the nurse recommend for the plan of care?

Choice A rationale:

Increased water intake is not a specific teaching point for fluoxetine. While general hydration is important for overall health, it's not directly related to the medication's effectiveness or side effects.

Fluoxetine is not known to cause dehydration or require fluid intake beyond typical recommendations.

Focusing on water intake could potentially distract from more relevant education about the medication.

Choice B rationale:

Sedation and sleepiness are common side effects of fluoxetine, especially during the initial weeks of treatment.

It's important for the client to be aware of these potential side effects so they can make necessary adjustments to their activities, such as avoiding driving or operating machinery if drowsy.

Understanding that these side effects are expected can also help with adherence to treatment, as clients may be less likely to discontinue the medication if they know that the side effects are likely to subside over time.

Choice C rationale:

Fluoxetine can sometimes cause sexual side effects, such as decreased libido or difficulty achieving orgasm.

It's important for the client to be aware of this potential side effect, but it's not accurate to say that they will definitely notice an improvement in their sex drive.

Sexual side effects can be distressing and may impact treatment adherence, so open communication with the healthcare provider is essential if these issues arise.

Choice D rationale:

Fluoxetine can take several weeks, typically 4-6 weeks, to fully exert its therapeutic effects.

Expecting to feel better within 3-4 days could lead to disappointment and frustration if symptom improvement isn't immediately noticeable.

It's important for the client to understand that patience is needed while the medication takes effect.

A rationale:

Going to another room and reading for 20 minutes when waking up at night is a recommended strategy for managing insomnia. This technique helps to break the cycle of lying in bed awake and worrying, which can worsen insomnia. Reading can be a relaxing activity that can help to promote sleepiness. It's important to choose a book that is not too stimulating and to avoid reading in bright light.

Choice B rationale:

Stopping napping in the afternoon is also a recommended strategy for managing insomnia. Napping can interfere with nighttime sleep by reducing sleep drive. It's best to avoid napping altogether or to limit naps to 30 minutes or less early in the afternoon.

Choice C rationale:

Watching television in the bedroom is not recommended for managing insomnia. The light from the television can suppress the production of melatonin, a hormone that helps to regulate sleep. The noise from the television can also be stimulating and make it difficult to fall asleep. It's best to avoid watching television in the bedroom or to turn off the television at least 30 minutes before bedtime.

Choice D rationale:

Eating the evening meal at least 3 hours before bed is generally a good practice for sleep hygiene. Eating too close to bedtime can lead to indigestion, which can make it difficult to fall asleep. It's best to avoid heavy, fatty, or spicy foods before bed.