A nurse is assessing a client who is taking losartan.
Which of the following findings should the nurse identify as an adverse effect of this medication?

Choice A rationale

A color-coded wristband, such as yellow, serves as a visual cue to all healthcare staff that a client has an increased risk of falling. This system promotes a universal understanding of the client's needs, allowing all members of the care team to implement appropriate fall prevention measures proactively and consistently, such as providing assistance with ambulation or frequent rounding.

Choice B rationale

The use of physical restraints, such as a restraint around the waist, is a last resort and requires a provider's order. It is not considered a primary fall prevention strategy. Restraints can increase a client's risk of injury and are associated with negative outcomes, including agitation, skin breakdown, and loss of muscle mass. Fall prevention strategies focus on proactive, non-restrictive interventions.

Choice C rationale

Storing personal items in a bathroom, especially on a high shelf, creates a significant fall hazard. The client may overreach or stand on a stool to retrieve items, increasing their risk of losing balance. To prevent falls, all personal items should be kept within easy reach of the client, such as on the bedside table, to minimize unnecessary movement.

Choice D rationale

While keeping some light on is helpful, having overhead lights on at all times can cause glare and create shadows that distort depth perception. This can make it difficult for a client with vision impairments to see potential obstacles. A low-level nightlight is a safer alternative for nighttime visibility, as it minimizes glare and helps maintain a normal sleep-wake cycle. *.

Choice A rationale

Storing transdermal scopolamine patches in the refrigerator is incorrect. Scopolamine patches are designed to be stored at controlled room temperature, typically between 20 to 25 degrees Celsius, to maintain the integrity of the adhesive and the stability of the medication. Refrigeration can compromise the patch's adhesive properties, potentially causing it to fall off, and may also affect the rate of drug delivery.

Choice B rationale

Replacing a dislodged patch onto the same location is incorrect. The skin's absorption capabilities at the initial site may be reduced due to the previous application, leading to a diminished therapeutic effect. Applying a new or dislodged patch to a new, clean, and dry site, typically behind the ear, ensures optimal drug absorption and efficacy, which is a crucial aspect of patient education.

Choice C rationale

Applying the patch prior to traveling is correct. Transdermal scopolamine requires a significant onset time to achieve therapeutic blood levels to effectively prevent the symptoms of motion sickness. The recommendation is to apply the patch at least four hours before the anticipated travel to allow for sufficient absorption and systemic distribution of the medication to the central nervous system.

Choice D rationale

Placing the patch on the upper arm is incorrect. The recommended application site for transdermal scopolamine is the postauricular area, which is the hairless skin behind the ear. This location offers a thin epidermis and a rich capillary network, facilitating consistent and effective absorption of the medication into the systemic circulation, which is essential for its prophylactic antiemetic effect. *.