Module 12: Cholinergic Drugs Affecting the Autonomic Nervous System

A patient with Parkinson's disease who is prescribed benztropine asks about the purpose of the drug. Which response should the nurse make?

"Benztropine is used to decrease the muscle tremors and rigidity."

A patient asks why dicyclomine was prescribed. Which information should the nurse provide about its use?

"It decreases gastrointestinal motility related to irritable bowel syndrome."

The nurse reviews the use of neuromuscular blockers and actions with a group of new colleagues. Which statement should indicate that teaching was effective?

"Neuromuscular blockers affect skeletal muscles in the somatic nervous system."

An older patient taking a cholinergic antagonist asks why fiber needs to be increased in the diet. Which response should the nurse make?

"These drugs slow peristalsis, causing constipation."

The nurse teaches about the use of donepezil (Aricept) for Alzheimer's disease. Which statement should indicate that additional teaching about the medication is required?

"This medication will cure Alzheimer's disease."

A patient taking bethanechol (Urecholine) asks when to expect to feel the effects of the medication. Which information should the nurse provide the patient?

30-60 minutes

A patient with an apical pulse of 44 beats/min reports dizziness. Which cholinergic antagonist should the nurse expect the healthcare provider to prescribe?

Atropine

A patient with bradycardia has glaucoma. Which drug should the nurse recall is contraindicated for this patient?

Atropine

A patient is diagnosed with urinary retention. Which medication should the nurse expect to be prescribed?

Bethanechol (Urecholine)

The nurse is preparing to administer a muscarinic antagonist to a patient. Which mechanism of action should the nurse expect from this drug?

Blocks cholinergic synapse receptors in the parasympathetic nervous system

An older patient is receiving atropine. For which side effect should the nurse add interventions to prevent injury in this patient?

Blurred vision

A patient reports long-term use of bethanechol (Urecholine). Which finding should indicate to the nurse that the medication is no longer effective?

Distended bladder

The nurse administers a muscarinic antagonist to a patient. Which response should the nurse expect that demonstrates suppression of acetylcholine at the receptor sites?

Drying of secretions

The nurse is preparing to administer bethanechol (Urecholine) to a patient with urinary retention. For which finding should the nurse realize this medication is contraindicated?

Epilepsy

The nurse notes that a patient is prescribed pilocarpine in the right eye three times a day. Which medical diagnosis should the nurse expect for this patient?

Glaucoma

The nurse notes that a patient with bradycardia is prescribed atropine. For which finding in the medical record should the nurse withhold the medication and contact the healthcare provider?

Glaucoma.

The nurse assesses a patient receiving a muscarinic agonist. For which finding should the nurse administer atropine?

Hallucinations and confusion

The nurse provides a dose of donepezil (Aricept) to a patient with new-onset Alzheimer's disease. Which outcome should the nurse expect in this patient?

Improvement in memory and cognitive function.

The nurse is asked to explain cholinergic drugs. In which area should the nurse explain these drugs act in the somatic nervous system?

In the neuromuscular junction, resulting in skeletal muscle contraction

A patient with pneumonia has increased dyspnea, crackles in the lung bases, and an oxygen saturation level of 89%. Which should the nurse expect to assess after administering ipratropium to this patient?

Increased oxygen saturation

A patient with a history of chronic obstructive pulmonary disease reports increased dyspnea at times during the day. Which muscarinic antagonist should the nurse suspect to be beneficial for this patient?

Ipratropium

A patient is prescribed a direct-acting cholinergic agonist. Which action should the nurse expect to occur from this medication?

It binds to acetylcholine receptors, enhancing the action potential on the postsynaptic neuron.

A patient is prescribed ipratropium. Which should the nurse teach the patient about this medication?

It causes bronchodilation and opens airways.

A patient with myasthenia gravis is prescribed pyridostigmine (Regonol). Which assessment finding should indicate that the medication is effective?

Lack of eye drooping

A patient is prescribed atropine. Which intervention should the nurse include in the plan of care for this patient?

Monitor heart rate and rhythm.

The nurse is reviewing the medication profile for a patient in the hospital. Which medication classification should the nurse identify that dries secretions?

Muscarinic antagonist

A patient with urinary retention is prescribed bethanechol (Urecholine). For which side effect should the nurse monitor the patient?

Orthostatic blood pressure changes

A patient reports problems with urge urinary incontinence. Which muscarinic antagonist should the nurse expect to be prescribed?

Oxybutynin

A patient is prescribed atropine. For which additional medication should the nurse question giving this medication?

Quinidine