Which client should the nurse prioritize for follow-up, considering potential complications?

Prioritizing the client taking lithium who reports nausea and vomiting is crucial due to the potential complications associated with lithium therapy. Lithium is a mood stabilizer used primarily in the treatment of bipolar disorder; however, it has a narrow therapeutic range, meaning that the difference between therapeutic and toxic levels is small. Nausea and vomiting are significant symptoms that could indicate lithium toxicity, especially if fluid and electrolyte imbalances occur as a result.

Monitoring the serum lithium level is essential in this scenario because elevated levels can lead to serious complications such as renal impairment, cardiac issues, and neurological effects. The nurse's follow-up is necessary to assess the client's condition, ensure hydration, and possibly adjust the medication dosage or provide treatment for any complications.

In contrast, the other clients each present situations that may require attention but do not have the same level of immediacy regarding life-threatening complications. A client refusing medication like quetiapine may need further discussion about their reasons for refusal, but it does not pose an immediate risk like potential lithium toxicity. A headache after taking citalopram is a common side effect and may warrant monitoring but isn't an urgent concern. Similarly, drowsiness after alprazolam is a known effect of the medication; while it