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 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."
Correct Answer is C
Explanation
Bethanechol is not indicated for the relief of severe pain following a transurethral resection of the prostate (TURP). Pain management for postoperative discomfort typically involves analgesics such as opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), depending on the severity of pain. Therefore, this option is incorrect.
B) Frequent episodes of painful urination:
While frequent episodes of painful urination may occur after a TURP due to irritation of the urinary tract, bethanechol is not typically administered to address this symptom. Painful urination is often managed with analgesics and may improve as the urinary tract heals. Therefore, this option is incorrect.
C) An inability to void:
This is the correct response. Bethanechol is a cholinergic agonist that stimulates bladder contraction and can be used to treat urinary retention or an inability to void following surgical procedures such as TURP. By increasing bladder tone and promoting urination, bethanechol helps relieve urinary retention and prevents complications associated with prolonged bladder distension.
D) Bladder spasms:
While bladder spasms may occur postoperatively following a TURP, bethanechol is not typically administered to address this symptom. Bladder spasms are often managed with anticholinergic medications or muscle relaxants to reduce involuntary contractions of the bladder. Therefore, this option is incorrect.”
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