A school nurse is planning a presentation about identifying potential warning signs of suicide for high school students. Which of the following examples of behaviors should the nurse include in the teaching?

A. A client who is taking a thiazide diuretic: Thiazide diuretics promote loss of potassium and hydrogen ions, leading to metabolic alkalosis rather than acidosis.

B. A client who has salicylate intoxication: Early salicylate toxicity causes respiratory alkalosis, though severe cases can progress to metabolic acidosis.

C. A client who has diarrhea: Chronic diarrhea leads to excessive bicarbonate loss, resulting in metabolic acidosis.

D. A client who is vomiting: Vomiting leads to loss of stomach acid (HCl), which causes metabolic alkalosis, not acidosis.

A. Hypotension, urinary retention, and blurred vision: These symptoms are more characteristic of anticholinergic toxicity rather than serotonin syndrome.

B. Dizziness, lethargy, and headache: These symptoms are non-specific and do not define serotonin syndrome, which involves neuromuscular, autonomic, and mental status changes.

C. Hypomania, arrhythmias, and panic attacks:. While serotonin syndrome can cause agitation, it does not cause hypomania (a mild form of mania). Arrhythmias can occur but are not a hallmark symptom.

D. Confusion, restlessness, tachycardia, and diaphoresis: Serotonin syndrome is characterized by mental status changes (confusion, agitation), autonomic instability (tachycardia, hypertension, hyperthermia), and neuromuscular abnormalities (hyperreflexia, tremors, clonus).