A nurse is reviewing the medical record of a female client who asks about a prescription for alendronate for the treatment of osteoporosis. Which of the following findings should the nurse identify as a safety risk for the client when taking this medication?

A. Hyperactive bowel sounds: Muscarinic agonist poisoning typically results in increased gastrointestinal motility and hyperactive bowel sounds. Atropine, an anticholinergic medication, works by blocking muscarinic receptors and reducing gastrointestinal motility. Therefore, the presence of hyperactive bowel sounds may indicate ongoing muscarinic stimulation and inadequate treatment with atropine.
B. Heart rate 90/min: Atropine is an anticholinergic medication that increases heart rate by blocking the parasympathetic effects of acetylcholine on the heart. Bradycardia is a common manifestation of muscarinic agonist poisoning, and an increase in heart rate following atropine administration indicates reversal of this effect and effective treatment.
C. Blood pressure 90/50 mm Hg: Atropine administration may result in transient hypertension due to its effect on increasing heart rate and cardiac output. Hypotension is a common
manifestation of muscarinic agonist poisoning, and an increase in blood pressure following atropine administration may indicate improvement in cardiovascular function. Therefore, a blood pressure of 90/50 mm Hg may not necessarily indicate effective treatment with atropine.
D. Increased salivation: Muscarinic agonist poisoning typically results in excessive salivation (sialorrhea) due to stimulation of muscarinic receptors in the salivary glands. Atropine administration works by blocking these muscarinic receptors and reducing salivation. Therefore, increased salivation would indicate ongoing muscarinic stimulation and inadequate treatment with atropine.

A. Increase in serum sodium: Desmopressin, a synthetic form of vasopressin, works to decrease urine output and increase water reabsorption in the kidneys. Therefore, a therapeutic response to desmopressin would not result in an increase in serum sodium; rather, it would aim to normalize serum sodium levels by reducing excessive urine output.
B. Decrease in urine output: The primary therapeutic goal of desmopressin in the treatment of diabetes insipidus is to decrease urine output by increasing water reabsorption in the kidneys. Therefore, a decrease in urine output would indicate a positive response to the medication.
C. Increase in heart rate: Desmopressin primarily affects kidney function by increasing water reabsorption and does not typically have a direct effect on heart rate. Therefore, an increase in heart rate would not be a manifestation of a therapeutic response to desmopressin.
D. Decrease in blood pressure: Desmopressin works to increase water reabsorption in the kidneys and does not typically cause significant changes in blood pressure. Therefore, a decrease in blood pressure would not be a manifestation of a therapeutic response to desmopressin.