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?

Choice A reason: Observing for Chvostek’s sign is appropriate when assessing for hypocalcemia, not when administering fluoxetine. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mood disorders. It does not affect calcium metabolism or neuromuscular excitability, so monitoring for Chvostek’s sign is irrelevant in this context. Choice B reason: Monitoring for changes in mental status is the correct intervention when initiating fluoxetine. SSRIs can cause side effects such as increased anxiety, agitation, or insomnia early in treatment. More importantly, they carry a risk of increasing suicidal ideation, especially in young adults and adolescents. Careful observation of mental status allows early detection of adverse psychiatric effects and ensures patient safety. This is the most appropriate nursing intervention when administering fluoxetine for the first time. Choice C reason: Evaluating therapeutic results within 12 hours of administration is unrealistic and inappropriate. Fluoxetine, like other SSRIs, requires several weeks (typically 2–4 weeks) to achieve therapeutic effects due to gradual changes in neurotransmitter regulation. Expecting results within hours would reflect a misunderstanding of the pharmacodynamics of antidepressants. Choice D reason: Administering ibuprofen to treat elevated temperature is unrelated to fluoxetine administration. Fluoxetine does not typically cause fever as a side effect. While serotonin syndrome can present with hyperthermia, this is a rare and severe adverse reaction that requires immediate medical intervention, not routine ibuprofen administration. Therefore, this option is not appropriate as a planned intervention.