A nurse is assessing a clie”t prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication?

Answer: A. “Syncope episodes may occur when taking this medication.”

Rationale:

A) “Syncope episodes may occur when taking this medication.”
Syncope (fainting) is a possible side effect of donepezil, a cholinesterase inhibitor used to treat Alzheimer’s disease. Donepezil can cause bradycardia, which may lead to a decrease in blood pressure and reduced blood flow to the brain, resulting in syncope. It's important for family members to monitor for episodes of dizziness, fainting, or lightheadedness, particularly when the client changes positions (orthostatic hypotension).

B) “You will need to monitor for constipation.”
Constipation is not commonly associated with donepezil use. In fact, donepezil may cause diarrhea or gastrointestinal upset due to its cholinergic effects. Family members should be more concerned about potential gastrointestinal disturbances such as nausea, vomiting, or diarrhea rather than constipation.

C) “This medication may cause tachycardia.”
Donepezil is more likely to cause bradycardia (a slower-than-normal heart rate) rather than tachycardia (a fast heart rate). Bradycardia is a known side effect because the medication increases acetylcholine, which enhances parasympathetic activity, leading to a slower heart rate.

D) “You should administer the medication each morning.”
Donepezil is typically administered in the evening before bed. This schedule helps reduce the risk of daytime gastrointestinal side effects, like nausea and vomiting, which can interfere with daily activities. Administering the medication at night can also reduce the impact of potential dizziness or syncope during the day.

A) "I should limit my fluid intake while taking this medication":
This statement is incorrect. Furosemide is a loop diuretic that increases urine production to reduce fluid overload in conditions like heart failure or edema. It is essential for clients taking furosemide to maintain adequate hydration to prevent dehydration. Therefore, the client should not limit their fluid intake while taking this medication.

B) "My blood pressure will increase while I am taking this medication":
This statement is incorrect. Furosemide is primarily used to reduce blood pressure by promoting diuresis and reducing fluid volume. Therefore, it is unlikely that blood pressure would increase while taking this medication.

C) "I should take this medication in the morning rather than at night":
This is the correct answer. Furosemide is usually taken in the morning to prevent nocturia (excessive urination at night), as it can increase urinary frequency. Taking it earlier in the day allows for better fluid balance during waking hours and reduces the need to wake up frequently during the night to urinate.

D) "I should eat a diet low in potassium while taking this medication":
This statement is incorrect. Furosemide can cause potassium depletion as a side effect, so clients may be advised to consume potassium-rich foods or supplements unless contraindicated due to other medical conditions. However, it is not necessary to eat a diet low in potassium while taking furosemide unless specifically instructed by a healthcare provider.