A nurse is evaluating a client who received intermittent IV fluids. Which of the following findings indicates the client has a fluid overload?

Choice A reason: Checking patency every 8 hours is inadequate for closed wound drainage systems, which require more frequent monitoring (e.g., every 4 hours) to detect blockages. Delayed checks risk fluid buildup, increasing infection or seroma risk, critical in postoperative wound management.
Choice B reason: Emptying the drainage system every 24 hours may be insufficient, as frequency depends on volume. Systems like Jackson-Pratt drains need emptying when half-full to maintain suction, preventing complications like infection, requiring flexible, volume-based schedules rather than fixed intervals.
Choice C reason: Securing the drainage system to the gown prevents dislodgement, maintaining suction and reducing infection risk. It supports mobility while stabilizing the system, preventing wound tension. This is critical for effective drainage and healing in postoperative clients with closed systems.
Choice D reason: Replacing the drainage system every 3 days is unnecessary unless infection or malfunction occurs. Routine replacement risks introducing pathogens or disrupting healing. Systems remain until drainage decreases, guided by clinical assessment, not a fixed schedule, to ensure safety.

Choice A reason: Performing ADLs independently is not a specific indicator of donepezil’s effectiveness, as it treats cognitive symptoms in Alzheimer’s, not physical function. While improved cognition may indirectly aid ADLs, this outcome is too broad and not directly tied to the medication’s primary action, making it incorrect.
Choice B reason: Increased food intake is not an expected outcome of donepezil, which targets acetylcholinesterase to improve cognitive function in Alzheimer’s. Appetite changes are unrelated to its mechanism, and this finding does not indicate effectiveness, making it an incorrect measure of the drug’s impact.
Choice C reason: Enhanced mood is not a primary effect of donepezil, which focuses on slowing cognitive decline. While mood may improve indirectly, it is not a direct indicator of efficacy. Other medications address mood in Alzheimer’s, making this finding less relevant and incorrect.
Choice D reason: Improved short-term memory is a key indicator of donepezil’s effectiveness, as it increases acetylcholine levels to slow cognitive decline in Alzheimer’s. Enhanced memory reflects the drug’s intended action, aligning with clinical expectations, making this the correct measure of therapeutic success.