A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

Rationale:

• HEENT – Dry mouth: SSRIs such as sertraline commonly cause dry mouth due to anticholinergic effects and altered salivary secretion. Clients may notice difficulty swallowing, increased thirst, or altered taste. Education should include strategies to manage dry mouth, such as frequent sips of water, sugar-free gum, or saliva substitutes.

• Cardiovascular – Tachycardia: Sertraline may increase sympathetic nervous system activity, leading to mild tachycardia. Clients should monitor heart rate and report palpitations, lightheadedness, or other cardiovascular changes. Although usually mild, monitoring is important for those with underlying heart conditions.

• Genitourinary – Urinary retention: SSRIs can interfere with detrusor muscle function and bladder emptying, leading to urinary retention in some clients. Teaching includes observing for difficulty urinating, straining, or reduced urine output, and reporting persistent problems to the provider.

• Gastrointestinal – Diarrhea: Gastrointestinal upset is common when starting SSRIs, including diarrhea, nausea, and abdominal cramping. This occurs due to increased serotonin in the gut. Patients should be advised to maintain hydration and report severe or persistent symptoms.

A. "This type of seizure can be mistaken for daydreaming.": Absence seizures are brief, sudden episodes of impaired consciousness, often with staring and subtle motor activity. Because these episodes are very short and the child resumes normal activity immediately, they can easily be misinterpreted as inattentiveness or daydreaming.

B. "This type of seizure lasts 30 to 60 seconds.": Absence seizures are typically very brief, usually lasting 5 to 10 seconds, rarely up to 15 seconds. A duration of 30 to 60 seconds is longer than expected and more characteristic of other seizure types.

C. "The child usually has an aura prior to onset.": Absence seizures do not usually have a preceding aura. Auras are more commonly associated with focal or partial seizures, not generalized absence seizures.

D. "This type of seizure has a gradual onset.": Absence seizures have a sudden onset and end abruptly. There is no gradual buildup of symptoms, which helps differentiate them from other neurological or behavioral events.