A nurse is caring for a school-age child who is receiving a continuous IV infusion through the right antecubital vein. Which of the following findings should the nurse recognize as a complication of IV therapy?

Rationale for correct choices

• Fatigue lasting longer than 4 months: Persistent fatigue can indicate an underlying chronic condition, autoimmune disorder, or neurological disease. Because it has lasted longer than several months, it warrants further assessment to rule out systemic or neurological causes. Chronic fatigue can significantly impair quality of life and functional capacity.

• Struggling to remember things and feeling depressed: Cognitive changes and mood disturbances may reflect neurological involvement, medication side effects, or comorbid depression. Memory issues combined with fatigue and mood changes require follow-up to assess for conditions affecting the central nervous system or systemic illness.

• Intermittent hand tremors: Hand tremors can indicate neurological disorders such as myasthenia gravis, Parkinsonism, or other neuromuscular conditions. Intermittent tremors, especially alongside muscle weakness and visual disturbances, warrant evaluation to determine the underlying etiology.

• Sudden episodes of leg weakness causing loss of balance and gait changes: Episodes of acute limb weakness with balance problems indicate potential neuromuscular dysfunction or demyelinating disease. These transient episodes impair safety and functional mobility, requiring further neurological evaluation to prevent injury.

• Intermittent muscle spasms: Muscle spasms are concerning when combined with other neuromuscular symptoms. They may indicate electrolyte imbalance, neuromuscular junction disorders, or early signs of autoimmune or neurological disease. Tracking frequency and triggers helps guide diagnosis.

• Occasional double vision: Intermittent diplopia may indicate cranial nerve involvement or neuromuscular junction pathology, such as myasthenia gravis. Even if infrequent, visual disturbances in combination with muscle weakness are red flags requiring neurological assessment.

• Genitourinary spasms: Spasms in the urinary tract may reflect neurological involvement or early autonomic dysfunction. Although infrequent, these symptoms can signal progression of a neuromuscular condition affecting bladder control and require follow-up to prevent complications.

Rationale for Incorrect findings

• Vital signs within normal limits: Temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation are all within normal ranges and do not currently indicate acute illness. No immediate intervention is required based on these values.

• Last bowel movement 1 day ago: Having a bowel movement within the last 24 hours is normal and does not indicate constipation or gastrointestinal dysfunction. No immediate follow-up is needed for bowel habits at this time.

A. Recommend the client begin behavioral therapy: Behavioral therapy, particularly cognitive-behavioral therapy (CBT), is the first-line treatment for gambling disorder. It helps the client identify triggers, develop coping strategies, and change maladaptive behaviors associated with gambling.

B. Request a referral for electroconvulsive therapy: Electroconvulsive therapy (ECT) is not indicated for gambling disorder. ECT is primarily used for severe depression or treatment-resistant psychiatric conditions and does not address behavioral addictions.

C. Request a prescription for a stimulant medication: Stimulants are not recommended for treating gambling disorder and could worsen impulsivity or addictive behaviors. Pharmacologic therapy, when used, typically involves SSRIs or opioid antagonists for specific symptom management.

D. Inform the client that hospitalization is not used for the treatment of a gambling disorder: While outpatient therapy is common, some clients may require short-term hospitalization if comorbid psychiatric conditions or severe psychosocial crises are present. Blanket statements about hospitalization are not appropriate as part of individualized care planning.