A nurse is teaching a class about pulmonary circulation. The nurse should include that blood flows from the heart to the lungs from the right ventricle starting from which of the following locations?

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.

Here's how to find the volume the nurse should administer:

Medication dose to be administered: 250 mg

Available medication concentration: 1000 mg/8 mL

We need to find the volume (in mL) that contains the desired dose (250 mg) of hydrocortisone sodium succinate.

Set up a proportion:

Desired dose (mg) : Volume to administer (mL) = Concentration (mg/mL) : Available volume (mL)

In this case:

Desired dose (mg) = 250 mg

Concentration (mg/mL) = 1000 mg/8 mL (available concentration)

Volume to administer (mL) = Unknown (what we need to find)

Available volume (mL) = 8 mL (volume of solution containing the concentrated medication)

Solve for the volume to administer (mL):

Volume to administer (mL) = (Desired dose (mg) x Available volume (mL)) / Concentration (mg/mL)

Volume to administer (mL) = (250 mg x 8 mL) / 1000 mg/mL

Calculate the volume:

Volume to administer (mL) = 2000 mg / 1000 mg/mL

Volume to administer (mL) = 2 mL (round to nearest whole number as requested)

Therefore, the nurse should administer approximately 2 mL of the hydrocortisone sodium succinate solution.