A nurse is caring for a client who has been prescribed fluoxetine for major depressive disorder. Which finding should the nurse recognize as a priority to report to the provider?

A. The client reports dry mouth and mild insomnia: These are common, mild side effects of selective serotonin reuptake inhibitors (SSRIs) like fluoxetine. They are generally self-limiting and manageable with supportive care or lifestyle modifications. B. The client reports new-onset agitation and thoughts of self-harm: New or worsening suicidal ideation, particularly during the first few weeks of SSRI therapy, is a critical safety concern. Increased energy from improved depressive symptoms can sometimes enable clients to act on existing suicidal thoughts. Immediate reporting to the provider is essential for risk assessment and intervention. C. The client reports improved energy and appetite: These findings indicate therapeutic improvement and response to treatment. They do not represent an adverse event and would not require urgent intervention. D. The client reports nausea and headache during the first week: Mild gastrointestinal or neurological side effects are common early in SSRI therapy. These symptoms typically resolve within days to weeks and are monitored but do not necessitate immediate reporting unless they worsen significantly.