A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?

STAT administration of atropine

administration of activated charcoal

hemodialysis

intravenous administration of pseudoephedrine

Answer and Explanation

The Correct Answer is A

A) STAT administration of atropine:
This is the correct answer. Atropine is a cholinergic antagonist that can increase heart rate by blocking the action of acetylcholine on cardiac muscarinic receptors. In cases of severe bradycardia, especially if associated with symptoms such as dizziness, syncope, or hypotension, atropine is often administered to increase heart rate and improve cardiac output. The dose of atropine and frequency of administration depend on the severity of bradycardia and the clinical response.

B) Administration of activated charcoal:
Activated charcoal is used in cases of overdose or poisoning to absorb ingested toxins and prevent their absorption into the bloodstream. However, in this scenario, where the primary concern is bradycardia resulting from cholinesterase inhibitor (donepezil) toxicity, activated charcoal would not be effective in reversing the bradycardic effects of the medication.

C) Hemodialysis:
Hemodialysis is a renal replacement therapy used to remove toxins and waste products from the blood in individuals with kidney failure. While hemodialysis may be indicated in cases of severe drug overdose or poisoning to enhance toxin elimination, it is not typically used as a first-line intervention for bradycardia associated with cholinesterase inhibitor toxicity.

D) Intravenous administration of pseudoephedrine:
Pseudoephedrine is a sympathomimetic drug that acts as a vasoconstrictor and can increase heart rate and blood pressure. While it may be used to treat bradycardia in some cases, such as severe symptomatic bradycardia unresponsive to atropine, it is not the first-line treatment for cholinesterase inhibitor toxicity-induced bradycardia. Atropine is preferred due to its direct antagonism of muscarinic receptors in the heart.

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Correct Answer is A

Explanation

A) "Take the medication with a full glass of water":
This is the correct answer. Docusate is a stool softener used to treat constipation by promoting the incorporation of water into the stool, making it softer and easier to pass. Taking docusate with a full glass of water helps facilitate its action by ensuring hydration and aiding in the softening of stool.

B) "Take this medication on an empty stomach":
Taking docusate on an empty stomach is not necessary. It can be taken with or without food. The primary consideration is to take it with an adequate amount of water to facilitate its stool-softening effect.

C) "Do not take this medication before bedtime":
There is no specific contraindication to taking docusate before bedtime. The timing of administration can vary based on individual preferences and bowel habits. Some individuals may prefer to take it before bedtime to promote a bowel movement in the morning, while others may take it at different times of the day.

D) "Expect abdominal pain with this medication":
Abdominal pain is an uncommon side effect of docusate. While it may occur in some individuals, it is not a common or expected reaction to the medication. Most people tolerate docusate well, but gastrointestinal side effects such as mild abdominal cramping, nausea, or diarrhea may occur in some cases.

A. The client should try to take in all of the required dietary fiber with the morning meal. B. The client should drink two to three 8 oz glasses of water each day. C. The client should follow a high-fiber diet to establish bowel regularity. D. The client should be taught that the goal of therapy is to have a bowel movement daily.

Correct Answer is C

Explanation

A) The client should try to take in all of the required dietary fiber with the morning meal:
While it's beneficial for clients to consume dietary fiber with meals to promote regular bowel movements, focusing solely on the morning meal may not provide adequate fiber intake throughout the day. It's essential for clients with chronic constipation to maintain a consistent intake of dietary fiber with each meal and snack.

B) The client should drink two to three 8 oz glasses of water each day:
Hydration is important for overall bowel health, but simply drinking water may not be sufficient to alleviate chronic constipation. While increasing fluid intake can help soften stools and prevent constipation, the amount of water needed varies among individuals. It's important for clients to drink enough fluids throughout the day to maintain hydration and support gastrointestinal function.

C) The client should follow a high-fiber diet to establish bowel regularity:
This is the correct answer. Increasing dietary fiber intake is a cornerstone of managing chronic constipation. A high-fiber diet can help add bulk to stools, improve bowel motility, and establish regularity. The nurse should educate the client about incorporating fiber-rich foods such as fruits, vegetables, whole grains, and legumes into their daily diet to promote optimal bowel function.

D) The client should be taught that the goal of therapy is to have a bowel movement daily:
While having a daily bowel movement may be a reasonable goal for some individuals, it's not universally applicable to all clients with chronic constipation. Bowel habits vary among individuals, and the frequency of bowel movements needed to establish regularity depends on factors such as diet, activity level, and overall health. The focus of therapy should be on achieving comfortable and regular bowel movements rather than a specific frequency.

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A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is preparing a teaching plan for a client who has chronic constipation secondary to irregular bowel habits. Which of the following should the nurse plan to include in the teaching?

Correct Answer is C

Explanation

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