Pharm chapter 21

A patient receives atropine eye drops before an eye examination. After the examination, what information should the nurse give the patient? "Do not drive for 24 hours." "Wear sunglasses for several hours." "Cover your eyes with patches for 3 hours." "Put in saline drops every 10 minutes after the examination."

"Wear sunglasses for several hours."

What should the nurse teach a patient about potential effects of a newly prescribed cholinergic-blocking drug? "The drug will decrease muscle rigidity." "The drug will cause a very slow heart rate." "You may have problems with urinary retention." "You will have increased saliva production and sweating."

"You may have problems with urinary retention."

A patient has been prescribed scopolamine for motion sickness. What information is essential for the nurse to teach the patient to prevent drowsiness and sedation? Place the patch on the upper torso. Do not drink alcohol while on this medication. Use this medication only on an empty stomach. Do not take the medication with caffeinated beverages.

Do not drink alcohol while on this medication.

What are the side effects of scopolamine? Dry mouth Drowsiness Blurred vision Altered mental status Respiratory depression

Dry mouth Drowsiness Blurred vision

The nurse is caring for a patient who has been prescribed tolterodine. What precaution is needed if the patient is also taking antibiotics for a urinary tract infection? Increasing water intake Evaluating liver function Administering the medication with food Administering the antibiotic 2 hours before the tolterodine

Evaluating liver function

The nurse is assessing a patient for adverse effects of a cholinergic-blocking medication. What assessments are essential to make? Heart rate Bowel sounds Pupil response Nutritional intake Neurologic status

Heart rate Bowel sounds Pupil response Neurologic status

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 fluids. Administer aspirin. Administer dicyclomine. Administer physostigmine.

Administer physostigmine.

The nurse is administering intravenous atropine to a patient who is also receiving an opioid. What intervention is essential? Determine the presence of infection. Determine whether the patient is hypertensive. Assess the patient's history for clotting disorders. Assess for compatibility of drugs to be mixed in the same syringe.

Assess for compatibility of drugs to be mixed in the same syringe.

What nursing interventions are essential before administering a cholinergic blocking drug? Assess heart rate. Assess medical history. Assess respiratory status. Assess complete blood count. Assess gastrointestinal system. Assess for peripheral vascular disease.

Assess heart rate. Assess medical history. Assess respiratory status. Assess gastrointestinal system.

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 should the nurse take? Assess respiratory status. Stop further doses of the medication. Administer the atropine as prescribed. Inform the primary health care provider. Administer intravenous activated charcoal.

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

A patient who is taking a cholinergic-blocking medication is having difficulty urinating. What is the nurse's best action? Insert a Foley catheter. Increase the patient's fluid intake. Assess the patient's medication therapy. Encourage the patient to ambulate frequently.

Assess the patient's medication therapy.

A patient accidentally took an overdose of a cholinergic drug at home. The patient reports severe abdominal cramping, dizziness, increased heart rate, and bloody diarrhea. What are the priority actions? Call 911. Administer atropine. Administer dicyclomine. Insert an intravenous line. Assess respiratory status. In the hospital, maintain electrocardiogram monitoring.

Call 911. Administer atropine. Insert an intravenous line. Assess respiratory status. In the hospital, maintain electrocardiogram monitoring.

For which therapeutic effect should the nurse assess a patient taking dicyclomine? Increase in heart rate Increase in blood pressure Decrease in urinary frequency Decrease in gastrointestinal (GI) motility

Decrease in gastrointestinal (GI) motility

The nurse is caring for a patient who has hepatitis and is prescribed tolterodine. What intervention is essential? Administer atropine. Increase fluid intake. Start an intravenous line. Decrease the dosage of medication.

Decrease the dosage of medication.

A patient who is scheduled for surgery receives atropine. For what should the nurse assess? Decreased urination Decreased blood pressure Decreased apical heart rate Decreased salivation and secretions

Decreased salivation and secretions

A patient is prescribed tolterodine. What should the nurse assess to determine the therapeutic effect of this medication? Increased heart rate Decreased urination Increased blood pressure Decreased bowel movements

Decreased urination

A patient is prescribed atropine. For what medication should the nurse assess the patient's history? Digoxin Cephalexin Erythromycin Aspirin therapy

Digoxin

The nurse should teach a patient receiving anticholinergic medications to avoid which medications that can lead to potential additive effects? Digoxin Antibiotics Amantadine Antihistamines Tricyclic antidepressants

Digoxin Amantadine Antihistamines Tricyclic antidepressants

What are potential side effects of administering high doses of a cholinergic-blocking medication? Disorientation Decreased heart rate Constriction of pupils Decreased gastric secretions Constriction of internal sphincter

Disorientation Decreased gastric secretions Constriction of internal sphincter

Which assessment finding in a patient who has received an anticholinergic drug requires immediate intervention? Hallucinations Motion sickness Decreased urination Increased respiratory rate

Hallucinations

A patient who has Parkinson disease is prescribed a high dose of an anticholinergic medication. What assessment findings may indicate adverse reactions to this dose? Hallucinations Increase in the heart rate Decrease in blood pressure Onset of shortness of breath Increase in body temperature

Hallucinations Increase in the heart rate Increase in body temperature

What is the expected therapeutic effect after the administration of atropine to a patient with cholinergic-blocker poisoning? Decrease in gastric secretions Immediate increase in heart rate Immediate decrease in heart rate Increase in respiratory rate within 1 minute

Immediate increase in heart rate

A cholinergic-blocking agent is administered to a patient with chronic bronchitis. What is the expected outcome of this therapy? Bronchoconstriction Increased secretions Increased respiratory rate Increased airflow to the lungs

Increased airflow to the lungs

Which assessment finding should the nurse interpret as a therapeutic effect of atropine? Lethargy Hypertension Increased heart rate Constriction of pupils

Increased heart rate

What assessment finding indicates the patient may have symptoms of anticholinergic drug overdose? Macular rash Severe headache Irregular heart rate Muscular weakness

Irregular heart rate

What is dicyclomine typically administered to treat? Enterocolitis Constipation Irritable bowel disease A neuromuscular blockade

Irritable bowel disease

A patient would like to use scopolamine to prevent motion sickness during an upcoming vacation. What factor in the patient's history will make this mediation a poor choice? Uses alprazolam for anxiety Is prescribed phenytoin for seizures Is prescribed imipramine for depression Is prescribed amantadine for Parkinson disease

Is prescribed imipramine for depression

What is the difficulty in using physostigmine as an antidote to an overdose of a cholinergic-blocking agent? It requires hospitalization. It requires supportive therapy. It can cause severe side effects. It requires increased fluid intake.

It can cause severe side effects.

The nurse administers dicyclomine to a patient. What assessment finding indicates the medication is therapeutic? The patient has decreased respiratory secretions. The patient has voided eight times in the last 2 hours. The patient has an increased heart rate and no chest pain. The patient has decreased bowel sounds and no complaints of cramping.

The patient has decreased bowel sounds and no complaints of cramping.

The nurse administered glycopyrrolate to a patient before surgery. What is the expected outcome? The patient will become drowsy. The patient will not have anxiety. The patient will have decreased pain. The patient will have decreased secretions.

The patient will have decreased secretions.

What medications are used for overactive bladder because of their decreased incidence of side effects such as dry mouth? Trospium Solifenacin Darifenacin Oxybutynin Fesoterodine

Trospium Solifenacin Darifenacin Fesoterodine

The nurse is caring for a patient who has a low-level spinal cord injury. What assessments and interventions are necessary? Muscular assessment and antispasmodic therapy Respiratory assessment and stimulant drug therapy Pain assessment and administration of intraspinal pain medication Urinary assessment and administration of cholinergic-blocking agents

Urinary assessment and administration of cholinergic-blocking agents

The nurse administers oxybutynin. What assessment is essential to determine therapeutic effect? Bowel sounds Urinary output Blood pressure Pupillary response

Urinary output

A patient has taken an anticholinergic agent along with an atypical antipsychotic drug. Which instruction should the nurse ensure the patient follows? "Avoid sun and warm places." "Avoid caffeinated beverages." "Drink additional fluids each day." "Expectorate oral secretions frequently."

"Avoid sun and warm places."

The nurse is providing education about cholinergic-blocking drug therapy to an older patient. What should the nurse include in the teaching plan about maximizing the therapeutic effects and minimizing the adverse effects of these drugs? "Eliminate high-fiber foods." "Brush your teeth frequently." "Drink 6 to 8 glasses of water daily." "Avoid exposure to high temperatures." "Begin an exercise program three times a week."

"Brush your teeth frequently." "Drink 6 to 8 glasses of water daily." "Avoid exposure to high temperatures."

What is important for the nurse to teach a patient who is prescribed an anticholinergic drug? "Brush your teeth twice daily." "Rinse your mouth frequently." "Drink at least 3 liters of water daily." "Take an over-the-counter antihistamine." "Suck on sugar-free candy whenever your mouth feels dry."

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

A patient who is going on a cruise is prescribed scopolamine transdermal patch. What will the nurse instruct the patient? "Do not drive a motor vehicle." "You should eat a low-fiber diet." "Do not consume too much water." "You should abstain from alcohol." "You should not use heavy machinery."

"Do not drive a motor vehicle." "You should abstain from alcohol." "You should not use heavy machinery."

The nurse is providing education to a patient who experiencing a dry mouth as a result of anticholinergic medication therapy. Which responses given by the patient indicate effective learning? "I should brush my teeth twice a day." "I should drink fifteen glasses of water per day." "I should schedule routine dental examinations." "I should incorporate high-fiber foods in my diet." "I should brush my teeth once daily to prevent pain."

"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." "I should keep the site covered to protect other people from exposure." "I may need to take a stool softener or laxative to relieve constipation." "I can use some sugar-free gum or sugar-free candy to treat my dry mouth."

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

What instructions should the nurse give a patient who has constipation from prolonged use of anticholinergic medications? "Get adequate rest." "Increase your daily intake of fluids." "Include nuts and legumes in your diet." "Increase the amount of fiber in your diet." "Take fiber supplements such as psyllium."

"Increase your daily intake of fluids." "Increase the amount of fiber in your diet." "Take fiber supplements such as psyllium."

A patient who has undergone treatment for spinal cord injury has been prescribed oxybutynin. What should the nurse teach the patient about taking this drug? "Take the medication after rinsing your mouth thoroughly." "Take the medication 1 hour before or 2 hours after meals." "Make sure you drink at least 6 to 8 glasses of water daily." "Suck on a piece of hard sugar candy after you take the pill."

"Take the medication 1 hour before or 2 hours after meals."

A patient who was prescribed transdermal scopolamine for motion sickness calls the clinic and states "I have had the patch on for 1 hour and I am feeling better now. Can I remove the patch?" What would be the nurse's best response? "You need another medication." "No, you cannot remove the patch for 3 days after it is applied." "The medication needs time to work if you are putting it on before travel." "Yes, you can remove the patch after an hour and put it back if you feel sick."

"The medication needs time to work if you are putting it on before travel."

The nurse administers 0.5 mg of atropine via intravenous push to a patient with sinus bradycardia. Which instruction should the nurse include in patient teaching? "Report blurred vision immediately." "Use ice chips to relieve dry mouth." "Expect minor urinary incontinence." "Anticipate lethargy and sleepiness."

"Use ice chips to relieve dry mouth."

What information regarding exercise should the nurse teach a patient who is receiving anticholinergic medications? "Only perform isometric exercise daily." "Exercise regularly to reach a target heart rate." "Avoid excessive sweating and strenuous exercise." "Exercise using large muscles such as with jogging or swimming."

"Avoid excessive sweating and strenuous exercise."

A patient receives a prescription for oxybutynin for the treatment of overactive bladder. Which instruction should the nurse include in patient teaching to help prevent adverse effects of therapy? "Empty your bladder at least every hour." "Manage increased salivation by drinking less." "Treat diarrhea with diphenoxylate and atropine." "Do not take antihistamines without your primary health care provider's approval."

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

The primary health care provider has prescribed transdermal scopolamine patches to treat motion sickness in a patient. What instructions should the nurse give to the patient about the medication? "Wear gloves when you put on the patch." "It is safe to take this medication with alcohol." "Apply the patch on the same area every time." "Place the patch on the nonhairy area behind your ear." "Apply the patch 4 to 5 hours before the activity that causes motion sickness."

"Place the patch on the nonhairy area behind your ear." "Apply the patch 4 to 5 hours before the activity that causes motion sickness."

The nurse is caring for a patient who is receiving anticholinergic drug therapy. What information should the nurse include in the teaching plan? "Decrease your fluid intake." "Stay out of the heat and humidity." "Include vitamin D in your daily diet." "Take the medication first thing in the morning."

"Stay out of the heat and humidity."

What is the medication dose of atropine that is used for symptomatic bradycardia? 0.3 mg 0.5 mg 1.25 mg 2 mg

0.5 mg

The nurse administers psyllium to a patient. Which assessment finding indicates a therapeutic response to this medication? Decreased urination A nonproductive cough A formed bowel movement No complaints of motion sickness

A formed bowel movement

Which patient cannot receive glycopyrrolate preoperatively? A patient with hepatitis. A patient with type 1 diabetes mellitus. A patient who is scheduled for gastric surgery. A patient with a genetic predisposition for breast cancer.

A patient with hepatitis.

Which finding in a patient's history is a contraindication to the administration of a cholinergic-blocking medication? Anxiety Irritable bowel disease Angle-closure glaucoma Gastrointestinal hypersecretory state

Angle-closure glaucoma

A patient is admitted with a cholinergic-blocker overdose. What treatment is appropriate? Nitroglycerin drip Activated charcoal administration Intubation and ventilatory support Continuous blood pressure monitoring Continuous electrocardiogram monitoring Intravenous diphenhydramine administration

Activated charcoal administration Continuous blood pressure monitoring Continuous electrocardiogram monitoring

The nurse has administered atropine intravenously to a patient who has sinus bradycardia. After administration of the medication, the patient's heart rate has not increased. What is the nurse's next course of action? Call a code. Call the respiratory team stat. Have the patient get up and move around. Administer another dose of the medication.

Administer another dose of the medication.

A patient is admitted to the emergency department with a suspected cholinesterase-inhibitor overdose. What is the nurse's primary action? Administer fluids. Monitor urinary output. Insert a Foley catheter. Attach the patient to a telemetry monitor.

Administer fluids.

An elderly patient has an overactive bladder. What is the initial intervention for this patient? Incontinence underwear Oxybutynin transdermal patch Behavioral modification therapy Oxybutynin extended-release tablets

Behavioral modification therapy

What should the nurse teach a patient to decrease the effects of dry mouth from an anticholinergic medication? Chew on ice chips. Brush teeth twice a day. Use artificial saliva drops. Maintain regular dental visits. Chew on sugarless candy or gum.

Brush teeth twice a day. Use artificial saliva drops. Maintain regular dental visits. Chew on sugarless candy or gum

An older adult receiving anticholinergic therapy should be assessed for what potential side effects of therapy? Coma Diarrhea Constipation Restlessness Blurred vision Pupil constriction

Constipation Restlessness Blurred vision

Which medication is used for the treatment of irritable bowel syndrome? Atropine Oxybutynin Dicyclomine Glycopyrrolate

Dicyclomine

What precaution is needed when physostigmine is administered to treat a cholinergic blocker overdose? Increased fluid intake Insertion of a Foley catheter Assessment of bowel sounds Frequent cardiac assessments

Frequent cardiac assessments

The nurse is caring for a patient with irritable bowel syndrome who has been prescribed dicyclomine. What finding in the patient's history is a concern in relation to this therapy? Arthritis Glaucoma Paralytic ileus Seizure disorder Myasthenia gravis

Glaucoma Paralytic ileus Myasthenia gravis

Which are contraindications for administration of cholinergic-blocking medications? Renal failure Peptic ulcers Down syndrome Bronchial asthma Recent heart surgery

Renal failure Down syndrome Recent heart surgery

A patient who is receiving anticholinergic drug therapy for overactive bladder reports having a dry mouth. What is a good course of action for this patient? Increasing fluids to 4 L daily Considering surgical therapy Stopping the medication therapy Switching to a newer medication

Switching to a newer medication

The nurse is caring for a patient with Parkinson disease who is receiving cholinergic-blocking drug therapy. What is the reason for prescribing this drug therapy to the patient? The drug decreases the urinary bladder spasms. The drug decreases muscle rigidity and tremors. The drug increases the patient's apical heart rate. The drug decreases gastrointestinal (GI) secretions.

The drug decreases muscle rigidity and tremors.

A patient has been prescribed oxybutynin. What will the nurse assess before administering the patient's next dose? Whether the patient has hypotension Whether the patient is able to urinate Whether the patient reports alcoholism Whether the patient has light sensitivity

Whether the patient is able to urinate