A nurse working at a mental health clinic is reviewing four messages from clients requesting a same-day appointment. Which client does the nurse prioritize to call back first?

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11ecbb05_cc51_db70_b433_7be08b5919ef_MD0009_00 Serotonin can be increased by the addition or high doses of serotonergic medication, or by some herbal medications (eg, St. John's wort), placing clients at risk for serotonin syndrome. Symptoms may include mental status changes (eg, anxiety, agitation, disorientation), autonomic dysregulation (eg, hyperthermia, diaphoresis, tachycardia/hypertension), and neuromuscular hyperactivity (eg, tremor, muscle rigidity, clonus, hyperreflexia). The nurse should call this client back to investigate the symptoms further. (Option A) Panic attacks can be frightening but typically last less than 10 minutes. A panic attack following a stressful event does not pose an immediate risk; the request for a refill of alprazolam (benzodiazepine for acute anxiety relief) can wait. (Option C) Phenelzine is a monoamine oxidase inhibitor that has multiple food interactions (eg, foods containing tyramine), which can cause hypertensive crisis. This client needs further education to prevent this condition, but is asymptomatic and not in immediate danger. (Option D) Stimulants (eg, methylphenidate, dextroamphetamine, lisdexamfetamine) are commonly used for attention-deficit hyperactivity disorder (in both children and adults) and are commonly associated with insomnia, irritability, diminished appetite, weight loss, and headaches. Educational objective: Serotonin can be increased by the addition or high doses of serotonergic medication, or by some herbal medications (eg, St. John's wort), placing clients at risk for serotonin syndrome.

A Nurse Working at a Mental Health Clinic Is Reviewing