A nurse is collecting data from a client who self-administers pilocarpine ophthalmic drops. Which of the following findings by the nurse indicates a systemic adverse effect of this medication?

a) Allergic rhinitis: Allergic rhinitis typically causes symptoms like sneezing, itchy eyes, and nasal congestion, but it does not typically present with the toothache-like pain or the fullness in the head seen in sinusitis.
b) Impacted wisdom teeth: Impacted wisdom teeth may cause pain in the jaw or gums, but they would not be associated with the fullness in the head or symptoms specific to sinus pressure.
c) Nasal polyps: Nasal polyps can cause nasal congestion or a runny nose, but they usually don't cause the specific symptoms of headache, facial pain, or fullness seen in sinusitis.
d) Sinusitis: The symptoms described (morning headaches, fullness in the head, and pain similar to a toothache under the eye) are indicative of sinusitis, an inflammation of the sinuses, which can cause these specific types of discomfort.

a) Coughing without letting food escape through the tracheostomy: After supraglottic laryngectomy, the patient may have difficulty swallowing and may require specific techniques to prevent aspiration.
b) Taking care of the tracheostomy, because the patient will always have to have one: While a tracheostomy may be necessary initially, not all patients will need it permanently.
c) Teaching the patient to swallow without aspiration: The loss of the normal anatomy for swallowing after supraglottic laryngectomy puts the patient at risk for aspiration. Rehabilitation and learning proper swallowing techniques are major postoperative concerns.
d) Teaching the patient to use an assistive device to speak: This is also an important consideration, but the primary issue postoperatively is managing swallowing to avoid aspiration.