A nurse is teaching the family of a client who has Alzheimer’s disease about donepezil. Which of the following information should the nurse include in the teaching?
“Syncope episodes may occur when taking this medication.”
“You will need to monitor for constipation.”
“This medication may cause tachycardia.”
“You should administer the medication each morning.”
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Hypoxemia:
This is the correct answer. Atelectasis, which is the collapse or incomplete inflation of the lung, can lead to impaired gas exchange and subsequent hypoxemia. As lung volume decreases due to collapse, ventilation-perfusion (V/Q) mismatch occurs, resulting in decreased oxygenation of arterial blood. Hypoxemia is a common finding in individuals with atelectasis and may manifest as decreased oxygen saturation levels on pulse oximetry or arterial blood gas analysis.
B) Apnea:
Apnea, defined as the cessation of breathing, is not typically associated with atelectasis. While atelectasis can contribute to respiratory compromise and may result in respiratory distress, including tachypnea or increased work of breathing, it does not usually lead to complete cessation of breathing.
C) Pleural effusion:
A pleural effusion is the accumulation of fluid in the pleural space surrounding the lungs. While pleural effusion may occur concurrently with atelectasis, it is not an expected finding specifically associated with atelectasis itself. Pleural effusion may cause respiratory symptoms such as dyspnea or chest pain but is not a primary manifestation of atelectasis.
D) Dysphagia:
Dysphagia, or difficulty swallowing, is unrelated to atelectasis. While dysphagia can occur as a result of various conditions affecting the esophagus or neurological control of swallowing, it is not a typical manifestation of atelectasis. Atelectasis primarily affects the lungs and respiratory function rather than swallowing function.
Correct Answer is C
Explanation
A) Respiratory rate 18/min:
A respiratory rate of 18/min is within the normal range for adults and is not a contraindication for administering atenolol. This finding does not warrant withholding the medication.
B) Oxygen saturation 95%:
An oxygen saturation of 95% is within the normal range and does not indicate any acute respiratory compromise. It is not a contraindication for administering atenolol.
C) Heart rate 46/min:
A heart rate of 46/min is below the normal range (typically 60-100 beats per minute for adults). Atenolol is a beta-blocker that primarily acts to reduce heart rate and blood pressure. Administering atenolol to a client with bradycardia (heart rate less than 60/min) can further decrease heart rate and may lead to symptomatic bradycardia or heart block. Therefore, the nurse should withhold atenolol in this case and notify the healthcare provider.
D) Blood pressure 160/94 mm Hg:
A blood pressure of 160/94 mm Hg indicates hypertension (elevated blood pressure). While atenolol is often prescribed for the management of hypertension, this blood pressure reading alone does not warrant withholding the medication. However, the client's bradycardia (heart rate 46/min)’is a more immediate concern that requires action."
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