Pharm EAQs Chapter 20
Which information would the nurse include in the teaching plan of a patient who has started to take donepezil?
"This medication will enhance your memory"
Which information should be in the teaching plan for a patient starting donepezil?
-"Your drug dose will be increased gradually" -"Get up slowly from a sitting or lying position" -"Tell your health care provider if you have gastric pain that does not subside"
Cholinesterase inhibitors are used for which purpose?
-diagnose and treat myasthenia gravis -an antidote in biochemical warfare -an antidote to tricyclic antidepressant toxicity
Cholinergic agonist drugs have the potential to cause which effects?
-increased respiratory secretions -decreased heart rate
Which intervention will increase peristalsis postop in a patient who has not had a bowel movement and who has hypoactive bowel sounds?
-inject bethanechol -provide a high fiber diet -administer a stool softener -ambulate patient as tolerated -increase fluid intake as tolerated
Which information does the nurse include regarding adverse effects when teaching a patient and family about a new prescription for donezepil (Aricept)?
-insomnia -hypotension -GI upset
Which drugs are used to reverse the effects of nondepolarizing neuromuscular blocking drugs after surgery?
-neostigmine -pyridostigmine -physostigme
Which assessment findings are adverse effects associated with the administration of cholinergic medications?
-sweating -dizziness -bradycardia -hypotension
When caring for a patient taking a cholinergic medication for urinary retention, the nurse assesses the patient for which adverse effects?
-sweating -increased salivation
Which assessment finding indicates an adverse reaction in a patient receiving bethanechol for the treatment of urinary retention?
-syncope -hypertension
Maximum safe dose of physostigmine that can be administerd to a patient in 2 hours:
12 mg
Which nursing action is a priority when administering a cholinergic medication for myasthenia gravis?
Administer 30 mins before meals
A patient taking rivastigmine is experiencing signs of a cholinergic crisis. Which medication would the nurse administer to improve the patient's condition?
Atropine
Which drug is the antidote to a cholinergic overdose?
Atropine
Which medication should be administered to a patient who has a cholinergic crisis?
Atropine
Which assessment finding in a patient receiving memantine indicates a significant side effect?
BP 70/40 mmHg
Which intervention will assist the patient in coping with orthostatic hypotension caused by cholinergic drug therapy?
Move from a sitting to standing position slowly
Which instruction does the nurse give to the patient who is starting therapy with pyridostigmine?
Take it before meals
Which conditions are contraindications for therapy with pyridostigmine?
asthma coronary artery disease
Which cholinergic medication is prescribed to a patient who is unable to void after surgery?
bethanechol
Which assessment finding is the result of parasympathetic nervous system stimulation?
bradycardia
used to reduce intraocular pressure
echothiophate
When obtaining a health history, the nurse looks for which diagnosis for a patient who is receiving pilocarpine eye drops twice a day?
glaucoma
Which condition is a contraindication for donepezil to treat symptoms of Alzheimer's disease?
heart block
Which condition is a contraindication to the administration of bethanechol?
hyperthyroidism
Which is an expected therapeutic outcome for a patient with Parkinson's disease and dementia who is prescribed rivastigmine?
improvement in memory
Which effect is caused by stimulation of the parasympathetic nervous system by a cholinergic drug?
increased GI motility
Which finding indicates donepezil is having a therapeutic effect?
increased cognition
Which assessment outcome indicates a therapeutic effect of the administration of pyridostigmine to a patient who has myasthenia gravis?
increased muscle strength
Which medication is a noncholinergic drug used in the treatment of Alzheimer's disease?
memantine
Which assessment finding indicates a therapeutic response to bethanechol in a patient with hypotonic bladder?
micturition within an hour
Which therapeutic outcome is expected from the administration of cevimeline to a patient with Sjogren's syndrome?
moist oral mucous membranes
Which drug is indicated in the treatment of myasthenia gravis?
neostigmine
Which route of administration is preferred for treating xerostomia with pilocarpine?
oral
Which drug may be administered to a patient who has a tricyclic antidepressant overdose?
physostigmine
Administration of which drug will assist in reversing neuromuscular blockade after general anesthesia?
physostigmine intravenously
Which medications are direct-acting cholinergic drugs?
pilocarpine -succinylcholine
Which medication may be administered to a patient who has myasthenia gravis?
pyridostigmine
used as an antidote for neuromuscular blocker toxicity
pyridostigmine
Bethanecol is used to treat which condition in a postop patient?
urinary atony