A nurse is caring for a client who has Alzheimer's disease and is going to transition from home to a skilled nursing facility. Which of the following interventions should the nurse incorporate into the plan of care to help the client with this transition and avoid relocation stress syndrome?

A. The client develops bradycardia and bradypnea: Bradycardia (slow heart rate) and bradypnea (slow breathing rate) may indicate a slowing down of bodily functions but are not typical manifestations of postoperative shock. In postoperative shock, the body's compensatory mechanisms often lead to tachycardia (rapid heart rate) and tachypnea (rapid breathing rate) as the body tries to maintain perfusion.

B. The client has metabolic alkalosis and warm extremities: Metabolic alkalosis and warm extremities are not typically associated with postoperative shock. In shock, metabolic acidosis is more common due to tissue hypoperfusion, and extremities may become cool due to peripheral vasoconstriction as the body attempts to shunt blood to vital organs.

C. The client has hypertension and anuria: Hypertension (high blood pressure) and anuria (lack of urine output) are not indicative of postoperative shock. In shock, blood pressure typically decreases (hypotension), and oliguria or anuria may occur due to decreased renal perfusion.

D. The client has hypotension and is confused: This is the correct answer. Hypotension (low blood pressure) is a hallmark sign of shock, indicating inadequate tissue perfusion. Confusion may occur due to cerebral hypoperfusion and inadequate oxygen delivery to the brain. Confusion is a late sign of shock and indicates severe compromise of organ perfusion.

A. "I should not drive while taking this new medication."

Carvedilol is a beta blocker commonly prescribed for conditions like cardiomyopathy. One of the potential side effects of beta blockers, including carvedilol, is dizziness or drowsiness. These effects can occur, particularly when starting the medication or when the dosage is increased. Therefore, it's crucial for patients to understand that they may experience these symptoms and should avoid activities that require alertness, such as driving or operating heavy machinery, until they are aware of how the medication affects them. This precaution helps ensure their safety and the safety of others on the road.

B. "This new medication may decrease my sex drive."

Sexual dysfunction, including decreased libido or erectile dysfunction, is a recognized side effect of beta blockers like carvedilol. These medications can affect the autonomic nervous system and interfere with normal sexual function in some individuals. It's essential for patients to be aware of this potential side effect and to discuss any concerns with their healthcare provider. Open communication about sexual health can help address any issues that arise and explore alternative treatment options if necessary.

C. "This medication can make me have mood swings."

While mood changes are possible side effects of some medications, including certain classes of antidepressants or corticosteroids, they are not typically associated with beta blockers like carvedilol. Beta blockers primarily affect the cardiovascular system by blocking the effects of adrenaline, leading to decreased heart rate and blood pressure. While some patients may experience fatigue or depression as a side effect of beta blockers, mood swings are not a common manifestation. Therefore, this statement does not accurately reflect the potential side effects of carvedilol.

D. "I may have frequent hiccups while taking this medication."

While gastrointestinal side effects such as nausea, vomiting, or diarrhea are possible with carvedilol, frequent hiccups are not a commonly reported side effect of this medication. Hiccups, though often benign, can occasionally be bothersome or indicative of an underlying issue. However, they are not typically associated with beta blockers like carvedilol. Therefore, this statement does not accurately reflect the potential side effects of the medication.

E. "I may have urinary incontinence while taking this medication."

Urinary incontinence is a potential side effect of beta blockers like carvedilol. These medications can affect bladder function by relaxing the smooth muscle of the bladder and urethra, leading to urinary retention or incontinence in some individuals. Patients should be aware of this possibility and discuss any urinary symptoms with their healthcare provider. Depending on the severity of the symptoms, adjustments to the medication regimen or additional treatments may be necessary to manage urinary incontinence effectively.