Client Name: Lilly Bowers Age: 36 years Medical History: Depression, asthma Current Medications: Albuterol Selective serotonin reuptake inhibitor (SSRI) Allergies: No known Nursing Note: Client presents to the clinic for a sick visit Client reports feeling flu-like symptoms with dizziness, nausea and vertigo, Reports has not been sleeping well at night and feels irritable Client states they have not used albuterol in over a month and stopped taking their SSRI because overall they have been feeling happy! Vital signs within normal limits. Review the electronic health record. The nurse is assessing the client. What is the most likely cause of the client's symptoms?

A. Discontinuation of the SSRI: Abrupt cessation of an SSRI can cause discontinuation syndrome, which often presents with flu-like symptoms, dizziness, nausea, vertigo, and sleep disturbances. Symptoms typically appear within days to a week after stopping the medication and can mimic a viral illness. Gradual tapering is recommended to prevent these withdrawal effects. B. Tested positive for COVID-19: While COVID-19 can produce flu-like symptoms, there is no information indicating exposure, testing, or characteristic respiratory findings. The timing of symptom onset in relation to SSRI discontinuation makes medication withdrawal a more likely explanation. C. The SSRI was at a toxic level: SSRI toxicity usually manifests as serotonin syndrome, which includes agitation, hyperreflexia, tremors, autonomic instability, and sometimes seizures. Lilly has normal vital signs and does not exhibit these severe neurologic or autonomic symptoms. D. Adverse effects of albuterol: Albuterol-related side effects generally include tremors, palpitations, and tachycardia, especially with recent or frequent use. Lilly has not used albuterol in over a month, making it an unlikely cause of her current symptoms.