A client has been receiving bupivacaine for localized pain relief. The client begins to report a metallic taste and is becoming increasingly agitated. Which can be used to treat this condition?

A. 2% lipid solution: A 2% lipid solution may not provide a sufficient lipid reservoir to effectively bind and sequester highly lipophilic local anesthetics like bupivacaine. Lower concentrations are generally inadequate for reversing systemic toxicity and may fail to prevent cardiovascular or neurologic complications. B. Acetylcysteine: Acetylcysteine is used primarily as a hepatoprotective agent in acetaminophen overdose and as a mucolytic. It does not interact with local anesthetics or mitigate systemic toxicity, and therefore is not appropriate for bupivacaine-induced adverse effects. C. 20% lipid solution: Intravenous lipid emulsion (20% lipid solution) is the treatment of choice for local anesthetic systemic toxicity (LAST), particularly with highly lipophilic agents such as bupivacaine. The lipid acts as a “lipid sink,” sequestering the anesthetic from target tissues, including the central nervous system and myocardium, thereby reducing toxicity. D. Propofol: Propofol is a general anesthetic and sedative-hypnotic agent used for induction and maintenance of anesthesia. While it may temporarily sedate a client experiencing CNS excitatory symptoms, it does not address the underlying mechanism of local anesthetic systemic toxicity and cannot reverse the effects of bupivacaine.