Chapter 27: Cholinergic Blocking Drugs

The nurse is educating a client who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the client? "Do not drive or operate machinery." "If you experience eye pain, contact the health care provider about increasing the dosage." "Increase your fluid intake and activity level." "Take long, hot showers frequently to relieve uncomfortable side effects."

"Do not drive or operate machinery."

The health care provider has ordered scopolamine transdermally for motion sickness. Which statement by the client, prescribed transdermal scopolamine, indicates an understanding of the medication's administration guideline? "I will place it on my chest each morning." "I will use it when I am sick to my stomach." "I will change the patch every 4 hours." "I will change the patch every 3 days."

"I will change the patch every 3 days."

A client who will be traveling on a ferry has been prescribed a scopolamine transdermal patch. What health education should the nurse provide to the client? "It's normal for your pupils to get smaller with this drug, so don't be surprised if someone points that out." "You might find that your heart beats more quickly than usual, even when you're at rest." "Some people have diarrhea when they first start taking this, but it will usually resolve on its own." "You might find yourself having to pass urine more often than you usually do."

"You might find that your heart beats more quickly than usual, even when you're at rest."

What is the recommended dosage for atropine for a client with a bradyarrhythmia? 0.2-0.4 mg 0.3-0.5 mg 0.4-0.6 mg 0.5-0.7 mg

0.4-0.6 mg

A client is receiving propantheline as adjunctive therapy for peptic ulcers. The nurse instructs the client to take the medication at which time? 30 minutes before meals 1 hour after meals Only as needed for symptom relief During a meal

30 minutes before meals

Which would the nurse include in a teaching plan for a client who is prescribed an anticholinergic agent? Avoiding activities that require alertness Encouraging outside activity in the warm weather Limiting fluid intake during the day Decreasing fiber intake

Avoiding activities that require alertness

A client who has been diagnosed with Parkinson's disease was prescribed levodopa. The client did not tolerate the administration of levodopa. Which medication will be administered in place of the levodopa? Carbamazepine Guanadrel sulfate Benztropine Nafcillin sodium

Benztropine

A male client, age 75, is started on flavoxate . What adverse effect should the client be made aware of? Skin rash Urinary incontinence Weight gain Blurred vision

Blurred vision

Which would a nurse least likely expect to assess in a client experiencing mild atropine toxicity? Dry mouth Cough Profuse sweating Increasing of heart rate

Cough

A client is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit the nurse would inquire about which? Chronic diarrhea Dental hygiene practices Headaches Diet

Dental hygiene practices

A client is experiencing symptoms of a hyperactive bowel. Which agent would the nurse expect to be ordered? Dicyclomine Glycopyrrolate Flavoxate Methscopolamine

Dicyclomine

Clients with what disorder should not be given anticholinergic drugs? Epilepsy Attention deficit disorder Glaucoma Severe anxiety or hyperactivity

Glaucoma

The client is scheduled for surgery in two hours. The physician orders preoperative administration of glycopyrrolate and meperidine. These drugs might be contraindicated for the client if the client had what disorder? Asthma Glaucoma Diverticulitis Diabetes mellitus

Glaucoma

A client with symptomatic bradycardia has been receiving atropine for the past 4 days and the client reports constipation. What is the most important suggestion the nurse could give the client? Avoid driving at night. Increase bulk in the diet. Suck on hard candies. Promote oral care.

Increase bulk in the diet.

A 70-year-old client is taking a cholinergic blocking drug. The family has noticed the client is a confused, excited, and not voiding normally. What would be the appropriate action by the nurse in this situation? Instruct the client's family to continue the medication and ignore the symptoms. Instruct the client's family to increase the dose of the medication to combat these symptoms. Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider. Instruct the client's family to take the client to the emergency department immediately.

Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider.

A client diagnosed with myasthenia gravis is experiencing rhinorrhea. Which medication should not be administered to the client? Azelastine hydrochloride Ipratropium Fexofenadine Nedocromil sodium

Ipratropium

A client is administered atropine to increase the heart rate. What is the action of atropine? It blocks the parasympathetic vagal stimulation. It exacerbates the parasympathetic vagal stimulation. It provides long-acting antihistamine blockage. It blocks cell wall synthesis of gram-negative bacilli.

It blocks the parasympathetic vagal stimulation.

A client has been prescribed an anticholinergic medication. What instructions should the nurse provide related to safety when outside in hot weather? Wear a hat to protect the head Wear sunglasses to protect the eyes Keep well hydrated Keep arms and legs covered

Keep well hydrated

An elderly woman is given scopolamine while on a cruise. She becomes very agitated and confused and is taken to the sick-bay of the ship. The nurse knows that which is a likely reason for these symptoms? Most elderly clients have dementia, which would prevent them from having normal, visual adverse reactions to cholinergic blocking drugs. Urinary retention often causes agitation. Older clients have a greater chance of adverse reactions to cholinergic blocking drugs. Elderly clients have more difficulty sleeping than regular clients, so the drowsiness that is a common side effect does not occur.

Older clients have a greater chance of adverse reactions to cholinergic blocking drugs.

Anticholinergics have varied effects on the body. What is one of those effects? Stimulating the release of acetylcholine Increasing respiratory tract secretions Preventing vagal stimulation Increasing secretion of sweat glands

Preventing vagal stimulation

Anticholinergic drugs are used in ophthalmology because they produce which effect? Sedation Pupil dilation Pupil constriction Decreased lacrimal secretions

Pupil dilation

A client is prescribed glycopyrrolate preoperatively. The nurse integrates understanding of the drug's action, explaining that this drug will help achieve which effect? Reduction of oral secretions Increase muscle rigidity Relaxation Prolongation of anesthesia

Reduction of oral secretions

Which anticholinergic agent is sometimes used to manage motion sickness when delivered by transdermal patch? Hyoscyamine Atropine Scopolamine Tolterodine

Scopolamine

The perioperative nurse is caring for a surgical client whose anesthesiologist has just administered atropine. When assessing the client, what finding should the nurse interpret as achieving the desired effect? The client expresses no anxiety about the administration of anesthesia. The client's pupils are dilated and minimally responsive to light. There is less than 50 mL of urine in the client's urinary catheter collection bag. There is no evidence of excessive oral or bronchial secretions.

There is no evidence of excessive oral or bronchial secretions.

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response? They block nicotinic receptors. They compete with serotonin for muscarinic acetylcholine receptor sites. They act to block the effects of the parasympathetic nervous system. They increase norepinephrine at the neuromuscular junction.

They act to block the effects of the parasympathetic nervous system.

The nurse is preparing a client for pacemaker surgery. The health care provider orders atropine to be given 30 minutes before the client is taken to the operating room. The nurse knows this medication is ordered for what reason? To increase the heart rate to prevent complication prior to the pacemaker being inserted To dry up respiratory secretions to prevent aspiration during surgery To cause bladder relaxation during surgery so that the client will not have the urge to void during surgery To relax the bowel to prevent the client from having a bowel movement during surgery

To dry up respiratory secretions to prevent aspiration during surgery

The client has recently developed extrapyramidal symptoms related to long-term administration of chlorpromazine. Which medication can be prescribed to assist in relieving these symptoms? Diazepam Darifenacin Trihexyphenidyl Trospium chloride

Trihexyphenidyl

A 78-year-old client is about to begin home care and has been prescribed an anticholinergic. What should the home care nurse explain to the client and her family about this medication? The client may benefit from additional fiber and fluids in her diet. The client may need assistance with ambulation. The client may be at increased risk of heat stroke. All the above

all the above

Older clients taking anticholinergic drugs are more likely to have which symptoms? blurred vision constipation hypertension confusion

blurred vision constipation confusion

Unwanted anticholinergic effects include: wakefulness, mental alertness, and decreased fatigue. drowsiness or sleep; decreased muscle tone; and decreased ability to move. increasing hyperactivity, excessive talking, nervousness, and insomnia. constipation and dry mouth.

constipation and dry mouth.

What is the primary goal for prescribing an anticholinergic agent for a preoperative client? prevent tachycardia decrease respiratory secretions decrease gastric motility relaxation of the detrusor muscle

decrease respiratory secretions

The nurse prepares to administer a preoperative anticholinergic to a client. What is a desired effect based upon the characteristics of the prescribed medication? wheezing heart rate 50 dry mucous membranes bilateral constricted

dry mucous membranes

A 75-year-old male client is started on flavoxate, an anticholinergic drug used in the treatment of overactive bladder. When teaching the client about the medication, the nurse should explain that the client may be at increased risk of: infection. hypothermia related to effects on body temperature regulation. diarrhea related to GI effects. falls related to visual effects.

falls related to visual effects.

Which symptom should the nurse monitor for when caring for a client whose sinus bradycardia has been treated with large doses of atropine? Pallor Flushing Edema Incontinence

flushing

The nurse is aware that cholinergic blocking agents will be used preoperatively for what type of anesthesia? Topical Local Regional General

general

A client is prescribed dicyclomine. The nurse would expect to administer this drug by which route? Oral Subcutaneous Transdermal Intravenous

oral