During a routine medical evaluation, a client is found to have a random blood glucose level of 310 mg/dL. Which client statements are concerning to the nurse? Select all that apply.

Choice A Reason:

I sleep at least 8 hours each night.

This statement is not concerning because getting adequate sleep is generally a sign of good health. It does not directly relate to symptoms of high blood glucose levels. Therefore, this choice is not relevant to the nurse’s concerns regarding the client’s elevated blood glucose level.

Choice B Reason:

I cannot seem to quench my thirst.

This statement is concerning because excessive thirst, known as polydipsia, is a common symptom of high blood glucose levels or hyperglycemia. When blood glucose levels are elevated, the body tries to eliminate the excess glucose through urine, leading to dehydration and increased thirst. This symptom indicates that the client’s blood glucose levels may be poorly controlled, which requires medical attention.

Choice C Reason:

I have to void nearly every hour.

Frequent urination, or polyuria, is another symptom of high blood glucose levels. When there is too much glucose in the blood, the kidneys work harder to filter and absorb it. When they can’t keep up, the excess glucose is excreted into the urine, pulling fluids from the tissues and causing frequent urination. This symptom is a clear indicator of hyperglycemia and needs to be addressed by the nurse.

Choice D Reason:

At times my vision is blurry.

Blurred vision can be a symptom of high blood glucose levels. Elevated glucose levels can cause the lens of the eye to swell, leading to changes in vision. This symptom is concerning because it suggests that the client’s blood glucose levels are affecting their vision, which can be a sign of poorly managed diabetes or other complications.

Choice E Reason:

I have lost 10 pounds without even trying.

Unintentional weight loss is a concerning symptom of high blood glucose levels. When the body cannot use glucose for energy due to insulin resistance or lack of insulin, it starts to break down muscle and fat for energy, leading to weight loss. This symptom indicates that the client’s diabetes may be uncontrolled, and immediate medical intervention is necessary.

Choice A Reason:

Low oxygen saturation is not a common side effect of donepezil. Donepezil is a cholinesterase inhibitor used to treat symptoms of Alzheimer’s disease by increasing the levels of acetylcholine in the brain. While it can have various side effects, respiratory issues like low oxygen saturation are not typically associated with this medication. Therefore, monitoring for low oxygen saturation is not a primary concern for patients starting donepezil.

Choice B Reason:

High blood pressure is also not a common side effect of donepezil. The medication primarily affects the central nervous system and does not typically cause significant changes in blood pressure. While it is always important to monitor a patient’s overall health, high blood pressure is not a side effect specifically linked to donepezil use. Therefore, it is not a primary focus for monitoring in this context.

Choice C Reason:

Elevated body temperature is not commonly associated with donepezil. The side effects of donepezil are more likely to involve gastrointestinal issues such as nausea, vomiting, and diarrhea, as well as muscle cramps and fatigue. Elevated body temperature is not a typical reaction to this medication, so it is not a primary concern for monitoring.

Choice D Reason:

Low pulse rate, or bradycardia, is a known side effect of donepezil. Donepezil can increase the levels of acetylcholine, which can affect the heart’s electrical conduction system and lead to a slower heart rate. This can be particularly concerning in elderly patients or those with pre-existing heart conditions. Therefore, it is crucial for the nurse to teach the family to monitor the client’s pulse rate regularly and report any significant decreases to the healthcare provider.