Autonomic Nervous System Pharmacology

A client with myasthenia gravis is receiving pyridostigmine bromide to control symptoms. Recently, the client has begun experiencing increased difficulty in swallowing. Which nursing action is effective in preventing aspiration of food?

Coordinate mealtimes with the peak effect of the medication.

A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse make to the client concerning this medication?

'Have an eye examination to check for glaucoma.'

Pyridostigmine bromide is prescribed for a client with myasthenia gravis. The nurse evaluates that the medication regimen is understood when the client makes which statement?

'I need to set an alarm so I take the medication on time.'

The health care provider prescribes neostigmine for a client with myasthenia gravis. Which client statement indicates understanding regarding medication management plans?

'I should take the medication at the exact time that is listed on the prescription.

Which instruction would the nurse give to clients prescribed psychotropic medications who are experiencing anticholinergic-like side effects?

'Suck on sugar-free hard candies.'

Nortriptyline is prescribed for a depressed client. Which time period identifies when the nurse would expect a therapeutic response?

2 to 3 weeks

To which nursing home resident could a nurse safely administer tricyclic antidepressants without questioning the health care provider's order?

A client with mild hypertension

Pilocarpine is used as part of the diagnostic process of a toddler suspected of cystic fibrosis. The nurse knows that the pilocarpine would stimulate which process?

Activity of sweat glands

Which action is likely to reduce the pancreatic and gastric secretions of a client with pancreatitis?

Administer prescribed anticholinergic medication.

The nurse in a urology office is developing a plan of care for a client newly diagnosed with urge urinary incontinence due to an overactive bladder. Which interventions should the nurse include?

Administration of anticholinergic drugs

When a client exhibits severe bradycardia, which type of medication will the nurse be prepared to administer?

Anticholinergic

An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client?

Apply the patch at least 4 hours prior to departure.

A client suspected of having myasthenia gravis is scheduled for an edrophonium chloride test. To treat a common complication associated with the test, the nurse will have which medication available?

Atropine

The nurse has administered fentanyl, atropine, cefazolin and benzocaine to a client for an endoscopic procedure. The nurse is monitoring the client and notes that the heart rate has increased from the pre-procedure baseline. The nurse knows that which of the following medications is most likely responsible for the client's increased heart rate?

Atropine

Which ophthalmic solution is contraindicated for clients with glaucoma?

Atropine

During a procedure, the client's heart rate drops to 38 beats/min. Which medication is indicated to treat bradycardia?

Atropine sulfate

A health care provider prescribes tolterodine for a client with an overactive bladder. Which action is important to include in client teaching?

Avoid activities requiring alertness until the response to medication is known

A client receiving fluphenazine decanoate develops dystonia/extrapyramidal side effect early in therapy. Which medication would the nurse anticipate administering to reverse this side effect?

Benztropine

A client develops extrapyramidal effects after taking a neuroleptic medication, and the nurse notes extrapyramidal effects. Which medication can limit these side effects?

Benztropine mesylate

A client with myasthenia gravis has been receiving neostigmine and asks about its action. Which information would the nurse consider when formulating a response?

Blocks the action of cholinesterase

Which body system is affected by excessive use of amphetamine / dextroamphetamine?

Cardiac

A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent?

Decreased muscle weakness

The nurse is caring for a client who has been prescribed atropine preoperatively. The nurse understands the intended purpose for administering this preoperatively is to induce which effect?

Decreased secretions

A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications are indicated to counteract the effects of stimulant intoxication? Select all that apply. One, some, or all responses may be correct.

Diazepam and propranolol

The nurse is teaching a client about tricyclic antidepressants. Which potential side effects would the nurse include? Select all that apply. One, some, or all responses may be correct.

Dry mouth, drowsiness, constipation, and orthostatic hypotension

An 80-year-old client with depression requires the prescription of antidepressant medication. Which tricyclic antidepressant medication causes fewer complications in older clients?

Nortriptyline

The nurse is teaching a nursing student about tricyclic antidepressant medications. Which statement made by the student indicates the need for further teaching? Select all that apply. One, some, or all responses may be correct.

Nortriptyline is contraindicated in older adult clients and tricyclic antidepressant medications are prescribed for clients with seizure disorders

Which statement accurately describes nortriptyline? Select all that apply. One, some, or all responses may be correct.

Overdosage is often lethal, constipation and urinary retention may occur, and weight gain is a common side effect

A client with Parkinson's disease is prescribed benztropine (Cogentin). For which of the following should the nurse call the health care provider immediately?

The client has a history of primary angle-closure glaucoma.

A client with myasthenia gravis begins taking pyridostigmine. Two days later, the client develops loose stools and increased salivation. Which conclusion would the nurse make about these new developments?

The medication is causing cholinergic side effects.

Which conclusion would the nurse make about the development of loose stools and increased salivation two days after a client with myasthenia gravis begins taking pyridostigmine?

The medication is causing cholinergic side effects.

A client presents to the clinic for a follow-up appointment after starting pyridostigmine for management of myasthenia gravis. Which new client problems are adverse effects of pyridostigmine? Select all that apply. One, some, or all responses may be correct.

Increased urinary frequency, muscle twitching, and diarrhea

Which test would the nurse identify as specific for the diagnosis of myasthenia gravis?

Edrophonium chloride test

) The nurse is teaching a client diagnosed with depression about a new prescription of nortriptyline. What information would be essential for the nurse to emphasize about this medication?

The use of alcohol should be avoided

The nurse is discharging a client with a new prescription for tiotropium to help manage the symptoms of chronic obstructive pulmonary disease. What information should the nurse include in the discharge teaching?

This medication cannot be used to relieve sudden breathing problems

Which medication class includes amitriptyline?

Tricyclics

Which adverse effect of imipramine requires further assessment and possible immediate medical intervention?

Urinary hesitancy

Cholinergic agonists are prescribed for which type of urinary condition?

Urinary retention

The health care provider prescribes a cholinergic medication to treat a client's urinary problem. Which effect would the nurse anticipate?

Urinary retention is prevented.

Which medication is indicated for emergency treatment of bleeding esophageal varices?

Vasopressin

Which nursing action is appropriate when administering imipramine?

Having the client checked for increased intraocular pressure

A 12-year-old child has just received a dose of epinephrine. Which assessment is the priority after this medication is administered?

Heart rate

Which side effect would the nurse assess for after epinephrine is administered to an infant with severe bronchospasms?

Tachycardia

The anticholinesterase medication pyridostigmine is prescribed for the client with myasthenia gravis. When providing medication teaching, the nurse explains that the client should expect a decrease in which function?

Heart rate

Pyridostigmine is prescribed for a client with myasthenia gravis. Why would the nurse instruct the client to take pyridostigmine about 1 hour before meals?

Taking it before meals improves the ability to chew.

nortriptyline. 5) A depressed client has been prescribed a tricyclic antidepressant. Which time period indicates how long it usually takes before the client notices a significant change in the depression?

2 to 4 weeks

The nurse is caring for a client who was recently prescribed atropine as a treatment for symptomatic bradycardia. Which condition should the nurse question as a contraindication when taking this medication?

Glaucoma

The nurse is reviewing the medical record of a client who received a new prescription for benztropine. For which condition in the client's record should the nurse clarify the prescription with the health care provider?

Glaucoma

A client is undergoing diagnostic testing for myasthenia gravis. Which test would the nurse identify as the most specific for this diagnosis?

Edrophonium chloride test

A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer?

Epinephrine

A client begins treatment with pyridostigmine bromide therapy for myasthenia gravis. Which action would the nurse perform in administration of the medication?

Evaluate the client's muscle strength every hour after the medication is given.

Which action would the nurse perform when beginning pyridostigmine bromide therapy for a client with myasthenia gravis?

Evaluate the client's muscle strength every hour after the medication is given.

Which drug category applies to cocaine?

Stimulants

The nurse is assessing an adolescent after the administration of epinephrine. Which side effect is most important for the nurse to identify?

Tachycardia

An 11-year-old client reports having bedwetting issues (enuresis). Which medication would the nurse anticipate when developing a teaching plan ?

Imipramine

A client with a history of methamphetamine use is admitted to the medical unit. Which clinical manifestation would the nurse expect when assessing the client who is under the influence on admission?

Increased heart rate