A nurse is caring for a 75-year-old patient who has been prescribed a new medication. The nurse knows that the process of converting the medication to a form that is easily excreted from the body is known as metabolism. Which consideration should the nurse take when administering this new medication?

A. The patient is unable to verbally respond when asked questions by the nurse:Advanced Alzheimer’s disease often results in loss of verbal communication. Nonverbal status is expected in late-stage disease and does not indicate an acute adverse reaction to donepezil. No immediate intervention is required for this finding.

B. The patient presented with black tarry stool when getting changed:Black, tarry stools (melena) indicate gastrointestinal bleeding, which is a serious adverse effect of cholinesterase inhibitors like donepezil due to increased risk of GI irritation or ulcers. This finding requires immediate nursing intervention, including notifying the healthcare provider and monitoring vital signs.

C. The patient displays a blood pressure reading of 110/72:A blood pressure of 110/72 mmHg is within normal limits for most adults. Donepezil can cause bradycardia or hypotension, but this reading alone does not indicate an urgent problem. Routine monitoring is sufficient.

D. The patient presented with black tarry stool when getting changed:The presence of melena indicates potential gastrointestinal bleeding and warrants immediate intervention.

A. Administer a potassium supplement to counteract the lightheadedness:Potassium supplementation does not prevent orthostatic hypotension caused by ACE inhibitors. Lightheadedness in this context is related to vasodilation and decreased blood pressure, not potassium deficiency.

B. Encourage the patient to skip doses of the ACE inhibitor to prevent lightheadedness:Skipping doses can lead to uncontrolled hypertension and increase cardiovascular risk. The lightheadedness should be managed with safe measures rather than interrupting prescribed therapy.

C. Stand up slowly from a sitting or lying position to avoid sudden drops in blood pressure:ACE inhibitors can cause orthostatic hypotension, particularly after the first dose. Slowly rising allows the cardiovascular system to adjust and reduces the risk of dizziness, fainting, or falls. This is a primary safety strategy for patients experiencing lightheadedness.

D. Increase the daily dose of the ACE inhibitor for better control of blood pressure:Increasing the dose could worsen hypotension and exacerbate lightheadedness. Dose adjustments should only be made by the healthcare provider based on blood pressure readings and tolerance, not to manage dizziness.