The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders (Select All that Apply.)

A) Check the client's perianal skin integrity:
Assessing perianal skin integrity is important in the care of a client with ulcerative colitis, particularly due to the potential for diarrhea and irritation. However, this is not the first priority upon admission for an acute exacerbation.

B) Educate the patient on which foods the patient should eat:
Nutritional education is crucial in managing ulcerative colitis, but it is not the priority during the initial assessment and admission for an acute exacerbation. Stabilizing the client's condition and addressing immediate needs take precedence.

C) Investigate the client's emotional concerns:
While emotional support is important, particularly in chronic conditions like ulcerative colitis, assessing emotional concerns is not the first action required upon admission for an acute exacerbation. Physical stabilization and assessment of the client's condition are the initial priorities.

D) Review the client's electrolyte values:
This is the correct answer. During an acute exacerbation of ulcerative colitis, there is a risk of electrolyte imbalance due to diarrhea and fluid loss. Reviewing the client's electrolyte values is crucial to assess the severity of dehydration and electrolyte imbalances, which can have immediate implications for the client's treatment plan and stabilization.

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.