A client is taking Saint John's wort and an SSRI. The nurse observes the client for which symptoms? (Select all that apply.)
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
1. Mania
2. Confusion
3. Renal failure
4. Tachycardia
5. Hypertension
Correct Answer: 1, 2, 3, 5
Rationale 1: Mania is a sign of serotonin syndrome, which can occur when Saint John's wort is taken with an SSRI.
Rationale 2: Confusion is a sign of serotonin syndrome, which can occur when Saint John's wort is taken with an SSRI.
Rationale 3: Renal failure is a sign of serotonin syndrome, which can occur when Saint John's wort is taken with an SSRI.
Rationale 4: Tachycardia is incorrect because this combination does not affect heart rate.
Rationale 5: Hypotension is incorrect because this combination would cause hypertension.
Global Rationale: Mania is a sign of serotonin syndrome, which can occur when Saint John's wort is taken with an SSRI. Confusion is a sign of serotonin syndrome, which can occur when Saint John's wort is taken with an SSRI. Renal failure is a sign of serotonin syndrome, which can occur when Saint John's wort is taken with an SSRI. Tachycardia is incorrect because this combination does not affect heart rate. Hypotension is incorrect because this combination would cause hypertension.
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