The nurse is caring for a client with a heart rate of 143 beats/min with atrial fibrillation. Which assessment data will the nurse anticipate? Select all that apply:

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.

Choice A Reason:

Weight gain is not typically associated with tuberculosis (TB). In fact, weight loss is a common symptom of TB due to the chronic nature of the infection and the body’s increased metabolic demands to fight the disease. Patients with TB often experience a loss of appetite and significant weight loss as the disease progresses.

Choice B Reason:

Low-grade fever is a common symptom of TB. The body’s immune response to the infection often results in a persistent low-grade fever, which can be one of the early signs of the disease. This fever is usually accompanied by other systemic symptoms such as night sweats and fatigue.

Choice C Reason:

Dyspnea, or difficulty breathing, can occur in patients with TB, especially if the infection has caused significant lung damage or if there is a large amount of fluid in the pleural space (pleural effusion). Dyspnea is a concerning symptom that indicates the need for further evaluation and treatment.

Choice D Reason:

Contusion, or bruising, is not a symptom associated with TB. TB primarily affects the lungs and can cause systemic symptoms, but it does not typically cause bruising. Contusions are more commonly associated with trauma or conditions that affect blood clotting.

Choice E Reason:

Lethargy, or a general sense of fatigue and weakness, is a common symptom of TB. The chronic nature of the infection and the body’s ongoing immune response can lead to significant fatigue. Patients with TB often feel tired and may have difficulty performing daily activities.

Choice F Reason:

Night sweats are a hallmark symptom of TB. Patients often experience drenching night sweats that can be quite severe. This symptom, along with fever and weight loss, is part of the classic triad of TB symptoms and is an important indicator for healthcare providers to consider TB in the differential diagnosis.