A nurse is teaching a newly licensed nurse about orthostatic hypotension. Which of the following information should the nurse include?

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.

A) The sympathetic nervous system is responsible for "fight or flight":
This is the correct answer. The sympathetic nervous system is responsible for the "fight or flight" response, which prepares the body to react to perceived threats or stressors by increasing heart rate, dilating pupils, redistributing blood flow, and releasing stress hormones such as adrenaline and noradrenaline.

B) The sympathetic nervous system helps us to rest and digest:
This statement is incorrect. The parasympathetic nervous system is responsible for the "rest and digest" response, which promotes relaxation, digestion, and conservation of energy.

C) The sympathetic nervous system includes the cranial nerves:
This statement is incorrect. The sympathetic nervous system is primarily associated with the thoracolumbar region of the spinal cord and does not include the cranial nerves, which are primarily associated with the parasympathetic nervous system.

D) The sympathetic nervous system can lower blood pressure:
This statement is incorrect. The sympathetic nervous system typically increases blood pressure as part of the "fight or flight" response by increasing heart rate and constricting blood vessels to redirect blood flow to vital organs and muscles.