A nurse is reviewing a medication reference prior to administering fluoxetine to a client for the first time. Which of the following interventions should the nurse plan to implement?

Introduction: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat depressive disorders by increasing synaptic serotonin levels, which requires careful monitoring for suicidal ideation and serotonin syndrome during the initial phase of therapy. A. Monitoring for changes in mental status is essential when initiating fluoxetine. SSRIs can cause an increase in suicidal ideation, particularly in children, adolescents, and young adults during the first few weeks of treatment. The nurse must assess for agitation, confusion, or sudden shifts in mood that may indicate a paradoxical reaction or the onset of serotonin syndrome. B. Evaluating therapeutic results within 12 hours is unrealistic for fluoxetine. Unlike some medications, antidepressants typically require 2 to 4 weeks of consistent administration before the client experiences a significant improvement in mood or depressive symptoms. Expecting immediate results can lead to premature discontinuation of the medication and a perceived failure of the treatment. C. Observing for Chvostek sign is an assessment for hypocalcemia, characterized by facial twitching when the facial nerve is tapped. This finding is not related to the administration of fluoxetine or its side effect profile. Fluoxetine monitoring focuses instead on neurological and gastrointestinal effects, such as tremors, insomnia, nausea, or sexual dysfunction. D. Administering ibuprofen for an elevated temperature in a client on fluoxetine is contraindicated without further evaluation. A fever could indicate serotonin syndrome, a life-threatening emergency. Furthermore, combining SSRIs with NSAIDs like ibuprofen increases the risk of gastrointestinal bleeding due to the antiplatelet effects associated with the inhibition of serotonin uptake in platelets.