A nurse is caring for a client 1 day postoperative who has developed atelectasis. Which of the following manifestations is an expected finding for this condition?

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.

A) Routinely exercise indoors:
Exercising indoors may be beneficial for individuals taking anticholinergic drugs to minimize the risk of heat-related complications. However, this option does not directly address the need to avoid extremes of temperature on exertion, which is crucial for preventing heat exhaustion and heat stroke. While indoor exercise can provide a controlled environment, it does not eliminate the risk entirely, especially if the indoor area is not adequately ventilated or air-conditioned.

B) Wear dark, warm clothing during the summer months:
Wearing dark, warm clothing during the summer months can exacerbate the risk of heat-related complications for individuals taking anticholinergic drugs. Dark clothing absorbs more heat from the sun, increasing body temperature, and warm clothing further contributes to heat retention. This option does not align with the goal of minimizing the risk of heat exhaustion and heat stroke.

C) Avoid extremes of temperature on exertion:
This is the correct answer. Avoiding extremes of temperature on exertion is essential for individuals taking anticholinergic drugs to reduce the risk of heat-related complications such as heat exhaustion and heat stroke. Exertion in hot environments can lead to excessive sweating and dehydration, further compromising thermoregulation. By avoiding extremes of temperature and moderating exertion, individuals can better regulate body temperature and minimize the risk of heat-related adverse effects.

D) Take frequent showers in the evenings and early mornings:
While taking frequent showers in the evenings and early mornings may help cool the body and reduce the risk of heat-related discomfort, it does not specifically address the need to avoid extremes of temperature on exertion. While personal hygiene practices are important, they should be supplemented with measures aimed at preventing heat-related complications, such as avoiding exertion in extreme temperatures. Therefore, this option does not fully meet the goal of minimizing the risk of heat exhaustion and heat stroke for individuals taking anticholinergic drugs.