A patient will begin taking a cholinesterase inhibitor for early Alzheimer disease. The nurse is teaching the patient's spouse about the medication. Which statement by the spouse indicates a need for further teaching?

A. This statement is accurate. Cholinesterase inhibitors work by enhancing the function of neurons that are still intact. They increase acetylcholine availability in the brain, helping remaining neurons communicate more effectively, but they do not repair already damaged neurons. B. This statement indicates a misunderstanding. Cholinesterase inhibitors do not significantly slow the progression of Alzheimer’s disease. They provide symptomatic improvement, such as better cognition, memory, and function for a limited time, but they do not alter the underlying neurodegenerative process. This shows the spouse requires further teaching about realistic expectations of the medication. C. This statement is correct. Antihistamines and other anticholinergic drugs can counteract the effects of cholinesterase inhibitors and worsen cognition. Caregivers should be educated to avoid concurrent use of anticholinergic medications unless specifically instructed by the provider. D. This statement is correct. Gastrointestinal symptoms, including nausea, vomiting, diarrhea, and loss of appetite, are common adverse effects of cholinesterase inhibitors. Nurses should educate caregivers on strategies to minimize these effects, such as taking the medication with food or starting with a low dose and gradually increasing.