A nurse is planning a community health program about Parkinson's disease. Which of the following interventions should the nurse include as a tertiary prevention strategy?

A) Edema: While edema can occur in some patients, it is not a common or serious side effect of simvastatin. Clients should monitor for any unusual swelling, but it is not the primary concern associated with this medication.

B) Weight loss: Weight loss is not typically associated with simvastatin use. Clients should be aware of their weight but reporting weight loss alone is not usually necessary unless it is significant or accompanied by other concerning symptoms.

C) Muscle weakness: Simvastatin can lead to muscle-related side effects, including myopathy and rhabdomyolysis, which can present as muscle weakness. It is critical for clients to monitor for any unexplained muscle pain, tenderness, or weakness and report these symptoms to the provider, as early intervention can prevent serious complications.

D) Fever: Fever is not a typical side effect of simvastatin. While clients should report any signs of infection or unusual symptoms, fever alone is not specifically linked to the use of this medication and does not warrant immediate concern related to simvastatin therapy.

A) Administer 1 L dextrose 5% in water IV bolus prior to the procedure: Administering a large volume IV bolus is generally unnecessary before a paracentesis. It can lead to abdominal distension and discomfort, potentially complicating the procedure. Fluid management should be carefully considered based on the client’s condition rather than a standard bolus.

B) Initiate NPO status 4 hr prior to the procedure: Paracentesis typically does not require NPO status unless sedation is planned, which is uncommon. Keeping the client NPO can cause unnecessary discomfort and does not align with standard pre-procedural care for a paracentesis, which usually allows for regular oral intake.

C) Position the client over an overbed table prior to the procedure: While positioning is crucial for comfort and access, clients are generally positioned sitting at the edge of the bed or in a semi-Fowler's position. An overbed table may not provide adequate support and could lead to discomfort or complications during the procedure.

D) Instruct the client to empty her bladder prior to the procedure: This action is important as it helps reduce the risk of bladder injury during the paracentesis and minimizes discomfort. An empty bladder allows for better access to the abdominal cavity, indicating that the nurse understands the necessary preparations for the procedure.