A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which instruction should the nurse emphasize?

Choice A Reason:

Antiretroviral medications are effective in decreasing AIDS-related complications. These medications work by reducing the viral load in the body, which helps to maintain the immune system and prevent the progression of HIV to AIDS. By keeping the viral load low, the risk of opportunistic infections and other complications associated with AIDS is significantly reduced.

Choice B Reason:

One of the primary goals of antiretroviral therapy (ART) is to decrease the viral load to an undetectable level. When the viral load is undetectable, it means that the amount of HIV in the blood is so low that it cannot be detected by standard laboratory tests. Achieving and maintaining an undetectable viral load is crucial for the health of the individual and helps to prevent the progression of the disease.

Choice C Reason:

It is important to understand that while antiretroviral therapy can control HIV infection and reduce the viral load to undetectable levels, it does not cure the infection. HIV remains in the body, and if the medication is stopped, the viral load will increase again. Continuous adherence to the medication regimen is necessary to keep the virus under control and maintain health.

Choice D Reason:

While antiretroviral therapy significantly reduces the risk of HIV transmission, it does not completely prevent it. The concept of “undetectable = untransmittable” (U=U) means that individuals with an undetectable viral load have effectively no risk of transmitting the virus through sex7. However, it is still important to use other preventive measures, such as condoms, to further reduce the risk of transmission.

Choice A Reason:

While keeping skin and eyes covered to protect from sun injury is generally good advice, it is not specifically related to the use of oxybutynin. Oxybutynin can reduce sweating, which increases the risk of overheating and dehydration, especially during physical activities like running a half-marathon. Therefore, this advice, while useful, is not the most critical in this context.

Choice B Reason:

Avoiding crowds to help prevent acquiring infections is important for overall health, especially for individuals with compromised immune systems. However, this advice is not directly related to the use of oxybutynin or the specific risks associated with its use during physical exercise. The primary concern with oxybutynin is its effect on sweating and body temperature regulation.

Choice C Reason:

Wearing padding to protect from bruising if a fall occurs is a precaution that might be relevant for individuals at risk of falls or injuries. However, this advice does not address the specific risks associated with oxybutynin use during physical exercise. The main concern is the potential for overheating and dehydration due to reduced sweating.

Choice D Reason:

Taking measures to avoid dehydration and overheating is the most critical instruction for a client using oxybutynin while training for a half-marathon. Oxybutynin can decrease sweating, making it harder for the body to cool down during exercise. This can lead to heat stroke or severe dehydration. The nurse should emphasize the importance of staying hydrated, taking breaks, and avoiding excessive heat to prevent these serious complications.