A nurse is teaching a client who has generalized anxiety disorder and a new prescription of buspirone. The nurse should instruct the client to notify the provider of which of the following findings as an adverse effect of buspirone?

A) "You will be allowed to drive yourself home within 6 hours following the procedure."This statement is incorrect. After an esophagogastroduodenoscopy (EGD), the patient is typically sedated, and the sedation can affect their alertness, coordination, and judgment. It is generally recommended that patients arrange for someone else to drive them home. It is unsafe for the patient to drive themselves after sedation, even if they feel alert. The nurse should instruct the client to have someone accompany them to the procedure and drive them home afterward.

B) "You might experience a hoarse voice for several days following the procedure."This statement is correct. A hoarse voice is a common and expected side effect after an esophagogastroduodenoscopy, as the procedure involves passing a flexible tube (endoscope) through the mouth and throat. The endoscope may cause irritation to the vocal cords or the lining of the throat, leading to a hoarse voice that can last for a few days. This is a normal, transient effect and should be explained to the patient in advance so they are not alarmed.

C) "You can have a clear liquid diet for breakfast prior to the procedure."This statement is incorrect. For most procedures like EGD, patients are typically instructed to fast for at least 6 to 8 hours prior to the procedure to ensure the stomach is empty. Having food or liquids before the procedure may increase the risk of aspiration or interfere with the examination. The nurse should educate the client to follow fasting instructions and avoid consuming any food or liquids, including clear liquids, as per the healthcare provider's guidelines.

D) "You should not take any of your routine medications until after the procedure is complete."

This statement is generally incorrect. Many patients are instructed to continue taking routine medications, especially if they are vital for managing chronic conditions, unless otherwise directed by the healthcare provider. In some cases, medications such as anticoagulants, aspirin, or certain blood pressure medications may need to be withheld temporarily before the procedure. However, the nurse should clarify with the healthcare provider which medications the client should stop or continue taking before the procedure. The patient should not withhold medications on their own without proper guidance.

A) Keep client in semi-Fowler's position with right extremity flat: Semi-Fowler's position is not optimal for a client with a compound fracture of the right tibia. Elevating the affected extremity, rather than keeping it flat, can help reduce swelling and pain.

B) Manage pain with oral opioids every 6 hr: While managing pain is crucial, oral opioids may not provide immediate relief needed in acute settings. Pain management should include a combination of strategies and may require IV analgesics for quicker relief.

C) Check capillary refill hourly for the first 24 hr: Although monitoring capillary refill is important to assess circulation, it is only one aspect of monitoring. Comprehensive assessment includes checking for signs of infection, neurovascular status, and compartment syndrome.

D) Apply a compression dressing over the fracture site: Applying a compression dressing can help control bleeding and reduce swelling. In a compound fracture, managing external bleeding and providing some stability to the fracture site are immediate priorities. However, the nurse should ensure this is done without compromising circulation and should be guided by physician orders.