A nurse is collecting data from a client who has been taking sertraline (Zoloft) for the past 2 weeks. Which of the following data collection findings should alert the nurse to the possibility that the client is developing serotonin syndrome?

A. Fever and lack of muscular coordination may indicate symptoms of serotonin syndrome, a potentially serious complication that can occur when sertraline (an SSRI) is combined with lithium.

B. Nausea and headache are common side effects of sertraline and lithium but are not typically indicative of a serious complication when these medications are used together.

C. Anxiety and insomnia may be related to the underlying condition being treated (e.g., depression) but are not necessarily indicative of a serious complication.

D. Dry mouth and constipation are potential side effects of lithium but are not typically indicative of a serious complication when combined with sertraline.

A. Sleepiness is not typically associated with a low lithium level.

B. A relaxed appearance is not typically associated with a low lithium level.

C. Calm behavior is not typically associated with a low lithium level.

D. A lithium level of 0.3 mEq/L is considered below the therapeutic range, which typically falls between 0.6 and 1.2 mEq/L. Therefore, a nurse would expect to assess symptoms of under-medication, such as potential recurrence of manic symptoms, such hyperactivity.