A nurse is assessing a client who is postoperative following a coronary artery bypass graft surgery. The nurse should identify that which of the following findings is an early indication of cardiac tamponade?

A. Disseminated intravascular coagulation: DIC is a rare, life-threatening condition associated with severe complications such as placental abruption or amniotic fluid embolism. The client currently has no signs or risk factors indicating DIC.

B. Preeclampsia: Preeclampsia is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. This client’s blood pressure is within normal limits, so preeclampsia is not an immediate concern at this time.

C. Placenta previa: Placenta previa involves implantation of the placenta over the cervical os, which would present with painless bright-red vaginal bleeding. The client’s lower back pain and pinkish discharge, along with contractions, do not suggest placenta previa.

D. Sepsis: The client has a fever (38.4° C / 101.1° F) and reports vaginal discharge, which could indicate an intrauterine or urinary tract infection. Infections during pregnancy can rapidly progress to sepsis, so the client is at increased risk and requires close monitoring.

E. Preterm prelabor rupture of membranes (PPROM): The client is experiencing uterine contractions at 33 weeks of gestation with pinkish vaginal discharge. These findings, along with her history of preterm birth, place her at risk for PPROM and preterm labor.

F. Seizures: Seizures are primarily associated with eclampsia or epilepsy. The client has no history of seizure disorder or signs of preeclampsia, making this complication unlikely at this time.

A. Increased food intake: While improved appetite may be beneficial, it is not a direct indicator of donepezil’s effectiveness. Donepezil primarily targets cognitive function rather than appetite or nutritional intake.

B. Improved short-term memory: Donepezil is a cholinesterase inhibitor that enhances cholinergic neurotransmission in the brain, particularly in areas involved in memory and learning. Improvement in short-term memory reflects the medication’s intended pharmacologic effect in slowing cognitive decline in clients with Alzheimer’s disease.

C. Enhanced mood: Mood changes are not the primary target of donepezil. Although improved cognition may indirectly affect emotional well-being, mood enhancement alone does not signify therapeutic efficacy of this medication.

D. Can perform ADLs independently: While maintaining independence in activities of daily living (ADLs) is a positive outcome, it may be influenced by multiple factors including physical health and environmental support. It is not a direct measure of donepezil’s effect on cognition.