When providing medication te”ching to a client who has been prescribed spironolactone for hypertension, what foods should the nurse instruct the client to avoid?

A) "Take the medication with a full glass of water":
This is the correct answer. Docusate is a stool softener used to treat constipation by promoting the incorporation of water into the stool, making it softer and easier to pass. Taking docusate with a full glass of water helps facilitate its action by ensuring hydration and aiding in the softening of stool.

B) "Take this medication on an empty stomach":
Taking docusate on an empty stomach is not necessary. It can be taken with or without food. The primary consideration is to take it with an adequate amount of water to facilitate its stool-softening effect.

C) "Do not take this medication before bedtime":
There is no specific contraindication to taking docusate before bedtime. The timing of administration can vary based on individual preferences and bowel habits. Some individuals may prefer to take it before bedtime to promote a bowel movement in the morning, while others may take it at different times of the day.

D) "Expect abdominal pain with this medication":
Abdominal pain is an uncommon side effect of docusate. While it may occur in some individuals, it is not a common or expected reaction to the medication. Most people tolerate docusate well, but gastrointestinal side effects such as mild abdominal cramping, nausea, or diarrhea may occur in some cases.

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.