When a patient with an overdose of antidepressants presents, which vital sign alteration should the nurse monitor most closely?

In the context of an antidepressant overdose, monitoring for cardiac dysrhythmias is crucial due to the potential for significant complications. Antidepressants, particularly tricyclics, can have a direct impact on cardiac conduction and rhythm, leading to arrhythmias that may be life-threatening. Dysrhythmias can result from the overdose's sedative effects and its ability to increase the risk of QT prolongation and other arrhythmic events, which can compromise hemodynamic stability and potentially lead to cardiac arrest if not addressed promptly.

Other vital sign alterations, although important, carry less immediate risk in the setting of antidepressant overdose. Elevated blood pressure may occur, but it typically does not pose as immediate a threat as cardiac dysrhythmias. Bradycardia might also be present, particularly in cases of severe toxicity, but it is generally less critical to monitor compared to the risk of dysrhythmias. Body temperature fluctuations can happen due to several causes but are not usually the most pressing vital sign change that could rapidly deteriorate a patient’s condition in this context. Thus, prioritizing the monitoring of cardiac dysrhythmias is essential for timely interventions and management in cases of antidepressant overdose.