A nurse is reviewing the medical history of a client who asks about the use of warfarin.
The nurse should identify which of the following findings as a contraindication for the administration of this medication?

Choice A rationale:

Improved short-term memory. Donepezil is a medication used to treat Alzheimer's disease and other forms of dementia. It works by increasing the levels of certain chemicals in the brain that are involved in memory, thinking, and reasoning. Therefore, improved short-term memory is an indication that the medication is effective, as it suggests enhanced cognitive function in the client.

Choice B rationale:

Enhanced mood. While improved mood can be a positive outcome of treating dementia, it is not the primary goal of donepezil therapy. The main focus is on cognitive improvement, particularly in memory and thinking skills. Enhanced mood alone may not be a reliable indicator of the medication's effectiveness in this context.

Choice C rationale:

Can perform ADLs independently. The ability to perform activities of daily living (ADLs) independently is an important aspect of a patient's overall well-being. However, this improvement may not solely be attributed to the effects of donepezil. Other factors, such as rehabilitation or support services, can also contribute to the patient's ability to perform ADLs. While it is a positive outcome, it is not a specific indication of donepezil's effectiveness.

Choice D rationale:

Increased food intake. Increased food intake is not a direct effect of donepezil. Donepezil does not have a primary role in regulating appetite or food intake. Therefore, this finding is not a reliable indicator of the medication's effectiveness in treating dementia.

The correct answer is Choice A.

Choice A rationale:

The client has influenza, which is a respiratory illness that can be transmitted through droplets when the infected person coughs, sneezes, or talks. The UAP is in close contact with the client while assisting them to sit up in bed to eat lunch. Therefore, it is necessary for the UAP to wear a face mask in addition to a gown and gloves to prevent the spread of the virus.This is in line with the Centers for Disease Control and Prevention (CDC) guidelines, which recommend that healthcare personnel wear a face mask when they are in the same room as a patient with suspected or confirmed influenza.

Choice B rationale:

A fitted respirator mask is not necessary in this situation.According to the Occupational Safety and Health Administration (OSHA), respirators are required for airborne diseases such as tuberculosis, but not for influenza, which is a droplet-transmitted disease. Therefore, reminding the UAP to apply a fitted respirator mask before entering the client’s room is not the most appropriate action.

Choice C rationale:

Assigning the UAP to provide care for another client and assuming full care of the client is not the most appropriate action in this situation. The UAP is already wearing a gown and gloves, which are part of the standard precautions for any patient care.The UAP just needs to add a face mask to their personal protective equipment (PPE) to safely assist the client.

Choice D rationale:

Instructing the UAP to notify the nurse of any changes in the client’s respiratory status is always a good practice. However, it does not address the immediate need for the UAP to wear a face mask while in close contact with the client. Therefore, it is not the most appropriate action in this situation.