A nurse has received change-of-shift report for four clients. Which of the following findings should the nurse report to the provider immediately?

Choice A reason: Loss of energy is a common symptom of depressive disorder and does not necessarily indicate an acute change or crisis. While it should be monitored and addressed in the care plan, it does not require immediate provider notification unless accompanied by suicidal ideation or functional decline. Choice B reason: Decreased urinary output in a client taking lithium is a potential sign of lithium toxicity or nephrotoxicity. Lithium can impair renal function and lead to serious complications such as acute kidney injury. Immediate reporting is essential to evaluate renal status, assess serum lithium levels, and prevent progression to toxicity. Choice C reason: A 2 lb weight gain over two weeks in a client taking an antipsychotic is not uncommon and may be related to metabolic side effects. While weight gain should be monitored, this amount is not alarming and does not require urgent provider notification unless it is rapid or accompanied by other symptoms like edema or hyperglycemia. Choice D reason: Difficulty recognizing objects (agnosia) in a client with dementia may reflect disease progression but is not an emergent finding. It should be documented and addressed in the care plan, but it does not require immediate provider intervention unless it is sudden or accompanied by other acute changes.