In a team meeting, a nurse says, "I’m concerned about whether we are behaving ethically by using restraints to prevent one patient from self-mutilation, while the care plan for another self-mutilating patient requires one-on-one supervision." Which ethical principle most clearly applies to this situation?

Choice A reason: Clozapine, an antipsychotic, primarily causes agranulocytosis and metabolic issues, not fluid or electrolyte imbalances. Its effects on the central nervous system and bone marrow do not directly disrupt electrolyte homeostasis, making this choice incorrect for this concern.

Choice B reason: Lithium, a mood stabilizer, affects renal function, impairing sodium and water reabsorption, leading to potential hyponatremia or dehydration. This requires close monitoring of electrolytes, as imbalances can cause toxicity, making this the correct choice for heightened alertness.

Choice C reason: Fluoxetine, an SSRI, primarily affects serotonin levels, with minimal impact on fluid or electrolyte balance. Side effects like nausea do not significantly disrupt electrolytes, making this choice incorrect compared to lithium’s known renal effects.

Choice D reason: Venlafaxine, an SNRI, influences serotonin and norepinephrine but does not significantly affect fluid or electrolyte balance. Its side effects, like hypertension, are unrelated to electrolyte homeostasis, making this choice incorrect for this specific concern.

Choice A reason: GABA is an inhibitory neurotransmitter that reduces neuronal activity, promoting calm. In fear, the sympathetic nervous system activates, increasing heart rate and blood pressure, driven by excitatory neurotransmitters, not GABA, which would counteract these effects, making this choice incorrect.

Choice B reason: Norepinephrine, a catecholamine, activates the sympathetic nervous system during fear, increasing heart rate and blood pressure via the fight-or-flight response. Its heightened activity in stress aligns with the patient’s symptoms, making this the correct neurotransmitter choice.

Choice C reason: Histamine regulates arousal and allergic responses but is not primarily responsible for cardiovascular changes in fear. Its role in the brain is less direct than norepinephrine in driving sympathetic activation, making this choice incorrect for the symptoms described.

Choice D reason: Serotonin modulates mood and anxiety but does not directly cause acute cardiovascular changes like increased heart rate and blood pressure in fear. These are driven by norepinephrine’s sympathetic activation, making serotonin an incorrect choice for this scenario.