A nurse in a long-term care facility is providing care for a client who has been receiving donepezil. Which of the following findings indicates that the medication is effective?

A. Incorrect. Premature atrial complexes do not typically affect the P-R interval. They are characterized by an early P-wave followed by a QRS complex.
B. Incorrect. Complete heart block is characterized by a dissociation between the P-waves and QRS complexes, resulting in no relationship between atrial and ventricular activity.
C. Incorrect. Atrial fibrillation is characterized by chaotic and irregular atrial activity without distinct P-waves, making the P-R interval irrelevant.
D. Correct. In first-degree atrioventricular block, the P-R interval is prolonged beyond the normal range of 0.12-0.20 seconds. A constant P-R interval of 0.35 seconds indicates a first- degree atrioventricular block.

Based on the provided information, the nurse should include the following statements in the client's teaching:

C. "Wear loose-fitting clothing": This is because the specific gravity of the urine is slightly elevated (1.022), which may indicate mild dehydration. Loose-fitting clothing can help promote comfort and ventilation, especially in cases of dehydration.

D. "Wear flat or low-heeled shoes": There is no specific indication related to the urine dipstick results, but it is generally good advice for maintaining proper foot health and preventing strain on the feet and ankles.

G. "You should avoid fried foods": There are no specific indications related to the urine dipstick results, but a healthy diet is always beneficial for overall well-being. Avoiding fried foods can be a part of a balanced diet and promote better health.

The following statements should not be included in the client's teaching based on the provided urine dipstick results:

A. "Try using an abdominal support belt": There is no indication related to the urine dipstick results that suggests the need for an abdominal support belt.

B. "Take hot showers to help relieve itching": Itching is not mentioned in the urine dipstick results, so there is no specific indication to recommend hot showers for this purpose.

E. "You can douche twice weekly": Douche is not related to urine dipstick results, and douching is generally not recommended as it can disrupt the natural balance of vaginal flora and may cause more harm than good.

F. "Eat two large meals a day": There is no indication related to the urine dipstick results that suggests a specific meal plan, and eating two large meals a day may not be suitable for everyone's dietary needs.

It's important for the nurse to provide teaching based on the client's specific needs and health conditions. In this case, the nurse can focus on maintaining hydration (based on the specific gravity result) and promoting a balanced diet and healthy lifestyle. Always individualize teaching based on the client's health status and any specific concerns they may have.