Pharm Ch. 21 Cholinergic-Blocking Drugs

A patient is admitted with a cholinergic-blocker overdose. Which treatment is appropriate? Select all that apply.

Activated charcoal administration Continuous blood pressure monitoring Continuous electrocardiogram monitoring

The nurse is caring for a patient who received atropine tablets for diarrhea. The nurse observes that the patient has mydriasis, altered mental status, and fever. What is the best action for the nurse to take?

Administer physostigmine.

Which finding in a patient's history is a contraindication to the administration of a cholinergic-blocking medication?

Angle-closure glaucoma

The nurse administers 5 mg of atropine every hour intravenously to a patient who has organophosphate poisoning. After administering the drug, the nurse observes tachycardia and dilation of the pupils. Which actions would the nurse take? Select all that apply.

Assess respiratory status. Stop further doses of the medication. Inform the primary health care provider.

A patient is admitted to the emergency department with a suspected cholinesterase-inhibitor overdose. Which action is the priority nursing intervention?

Attach the patient to a telemetry monitor.

An elderly patient has an overactive bladder. Which initial intervention for this patient is appropriate?

Behavioral modification therapy

For which therapeutic effect would the nurse assess in a patient taking dicyclomine?

Decrease in gastrointestinal (GI) motility

The nurse is caring for a patient who has hepatitis and is prescribed tolterodine. Which intervention by the nurse is essential?

Decrease the dosage of medication.

The nurse administers dicyclomine to a patient. Which assessment finding indicates the medication is therapeutic?

Decreased bowel sounds and no complaints of cramping

A patient who is scheduled for surgery receives atropine. Which effect would the nurse assess for?

Decreased salivation and secretions

A patient is prescribed tolterodine. Which parameter would the nurse assess to determine the therapeutic effect of this medication?

Decreased urination

Which medication is used for the treatment of irritable bowel syndrome?

Dicyclomine

A patient is prescribed atropine. Which medication would the nurse assess for in the patient's history?

Digoxin

Which symptoms are potential side effects of administering high doses of a cholinergic-blocking medication? Select all that apply.

Disorientation Decreased gastric secretions Constriction of internal sphincter

Which symptoms are side effects of scopolamine? Select all that apply.

Dry mouth Drowsiness Blurred vision

The primary health care provider has prescribed glycopyrrolate to a patient. Before administration, the nurse assesses the patient's history. Which conditions would be contraindications for the administration of this medication? Select all that apply.

Glaucoma Ulcerative colitis Gastroesophageal reflux disease

Which assessment finding in a patient who has received an anticholinergic drug requires immediate intervention?

Hallucinations

A patient who has Parkinson's disease is prescribed a high dose of an anticholinergic medication. Which assessment findings may indicate adverse reactions to this dose? Select all that apply.

Hallucinations Increase in the heart rate Increase in body temperature

Which assessments are essential before administering a cholinergic-blocking drug? Select all that apply.

Heart rate Medical history Respiratory status Gastrointestinal system

After administration of a cholinergic-blocking drug, the nurse assesses the patient. Which finding requires immediate action?

Heart rate 110 beats/min

Which patient condition is a contraindication to receiving glycopyrrolate preoperatively?

Hepatitis

Which response is the expected therapeutic effect after the administration of atropine to a patient with cholinergic-blocker poisoning?

Immediate increase in heart rate

Which assessment finding would the nurse interpret as a therapeutic effect of atropine?

Increased heart rate

A patient would like to use scopolamine to prevent motion sickness during an upcoming vacation. Which factor in the patient's history will make this mediation a poor choice?

Is prescribed imipramine for depression

Why is use of physostigmine as an antidote to an overdose of a cholinergic-blocking agent controversial?

It can cause severe side effects.

A patient who is receiving anticholinergic drug therapy for overactive bladder reports having a dry mouth. Which course of action is appropriate for this patient?

Switching to a newer medication

The nurse is caring for a patient with Parkinson's disease who is receiving cholinergic-blocking drug therapy. Why was this drug therapy prescribed for the patient?

To decreases muscle rigidity and tremors

Which medications are used for overactive bladder because of their decreased incidence of side effects such as dry mouth? Select all that apply.

Trospium Solifenacin Darifenacin Fesoterodine

Which assessment findings may indicate a need for therapy for overactive bladder syndrome? Select all that apply.

Urinating every hour Sudden and strong urge to urinate Urinating more than two times at night

Which information is important for the nurse to teach a patient who is prescribed an anticholinergic drug? Select all that apply.

"Brush your teeth twice daily." "Rinse your mouth frequently." "Suck on sugar-free candy whenever your mouth feels dry."

A patient receives a prescription for oxybutynin for the treatment of overactive bladder. Which instruction would the nurse include in patient teaching to help prevent adverse effects of therapy?

"Do not take antihistamines without your primary health care provider's approval."

The nurse is providing education to a patient who is experiencing a dry mouth as a result of anticholinergic medication therapy. Which responses given by the patient indicate effective learning? Select all that apply.

"I should brush my teeth twice a day." "I should schedule routine dental examinations."

A patient is prescribed a transdermal preparation of a muscarinic antagonist for overactive bladder. The nurse teaches the patient about methods to alleviate side effects of the medication. Which statement by the patient indicates the need for further teaching?

"I will take diphenhydramine for any itching caused by the patch."

Which instruction would the nurse provide to a patient about potential effects of a newly prescribed cholinergic-blocking drug?

"You may have problems with urinary retention."

Which dose of atropine is used for symptomatic bradycardia?

0.5 mg

The nurse administers psyllium to a patient. Which assessment finding indicates a therapeutic response to this medication?

A formed bowel movement