Focus Nursing Pharmacology Chapter 33 Prepu – Flashcards
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Some anticholinergic drugs have the same clinical indications in the pediatric population as in the adult population. Which of the following statements accurately describes a difference between the populations related to the use of anticholinergics?
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Adverse effects tend to be more severe in children.
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Which agent would a nurse expect to administer transdermally
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Scopolamine
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A male client is diagnosed with IBS, and the physician orders an antispasmodic. Which drug should the nurse be prepared to administer to this client?
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Glycopyrrolate
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A 75-year-old male client is experiencing extrapyramidal symptoms secondary to an antipsychotic drug. Which drug would the nurse expect the physician to order to relieve these symptoms?
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Anticholinergics
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A 78-year-old female patient who is about to begin home care has been prescribed anticholinergic drugs. Which of the following should the home care nurse explain to the patient and her family?
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All the above
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A patient is administered atropine to increase the heart rate. What is the action of atropine?
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It blocks the parasympathetic vagal stimulation.
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A patient is prescribed dicyclomine. The nurse would expect to administer this drug by which route?
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Oral
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Because of the systemic effects of anticholinergic drugs, patients using these drugs are more susceptible to
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heat stroke related to decreased perspiration.
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While preparing your client for an eye examination, you explain that the eye drops, an ophthalmic anticholinergic preparation, will cause the pupil to:
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Dilate.
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A male client is prescribed an anticholinergic drug by his physician. He likes to hike with his grandchildren. The home care nurse instructs the client that anticholinergic medications have which effect?
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Prevents sweating and heat loss and increasing the risk of heat stroke
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The physician has ordered scopolamine transdermally for motion sickness. Which of the following statements by the patient indicates an understanding of the medication's administration guideline?
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I will change the patch every 3 days."
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A patient has been administered atropine for sinus bradycardia. Which of the following symptoms is noted with large doses of atropine?
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Flushing
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A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the physician's office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the physician to do for this client?
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Explain to the client that the medication is contraindicated because of her medical history
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Which agent would a nurse expect to administer transdermally?
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Scopolamine
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Anticholinergic drugs are used in ophthalmology to
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dilate the pupils.
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The nurse is educating a patient who has been prescribed atropine, an anticholinergic drug. Which of the following instructions should the nurse provide to the patient?
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"Do not drive or operate machinery."
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An older client is taking an anticholinergic agent. After teaching the client about the drug, which client statement indicates the need for additional teaching?
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"I need to exercise frequently outside in the warm weather."
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Atropine is derived from the belladonna plant.
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True
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When describing the various anticholinergic agents to a group of students, the instructor would identify which agent as being available in sublingual form?
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Hyoscyamine
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A patient has been administered atropine for sinus bradycardia. Which of the following symptoms is noted with large doses of atropine?
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Flushing
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After receiving a preoperative dose of atropine, a 50-year-old patient complains of mouth dryness. How would the nurse explain this effect?
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The medication temporarily decreased your salivation."
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Anticholinergic agents are also called parasympatholytic agents
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True
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Which of the following agents would be least likely to cause increased adverse effects if given with an anticholinergic agent?
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Nonsteroidal anti-inflammatory drugs
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After teaching a patient who is prescribed a scopolamine patch, the nurse determines that the teaching was successful when the patient states that she will change the patch in which time frame?
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Every 3 days
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An elderly woman is given scopolamine while on a cruise. She becomes very agitated and confused. The nurse knows that which of the following is a likely reason for these symptoms?
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Older clients have a greater chance of adverse reactions to cholinergic blocking drugs.
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After teaching a group of students about anticholinergic agents, the instructor determines the need for additional teaching when the student's identify which of the following as a contraindication for use?
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Hypertension
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A patient is experiencing symptoms of a hyperactive bowel. Which agent would the nurse expect to be ordered?
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Dicyclomine
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James has symptomatic bradycardia. He has been receiving atropine for the past 4 days. He now complains about constipation, a common adverse effect of the drug. What is the most important suggestion the nurse could give James?
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Increase bulk in the diet
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Anticholinergics block acetylcholine at the muscarinic receptors.
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True
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A patient who is going on a cruise is concerned about motion sickness and sees his physician, who prescribes scopolamine. The nurse informs the patient that using scopolamine may cause him to experience
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drowsiness.
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A woman 70 years of age is taking a cholinergic blocking drug. Her family has noticed that she is very excited, a little confused, and complains of not being able to void normally. What action by the nurse would be most appropriate to deal with these symptoms?
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Instruct the client to withhold the next dose and contact the prescribing provider.
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The nurse is preparing Mr. Hahn for pacemaker surgery. The physician orders atropine to be given 30 minutes before the patient leaves for the operating room. The nurse knows that the physician ordered this medication for what reason?
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To dry up respiratory secretions to prevent aspiration during surgery
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The nurse administers atropine intramuscularly at 9:00 AM. At which time would the nurse expect the drug's peak effects to occur?
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9:30 AM
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Anticholinergics do not block the effects of acetylcholine in the central nervous system.
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False
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Unwanted anticholinergic effects include:
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Constipation and dry mouth
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A male client asks the nurse why he needs the preoperative anticholinergic medication ordered by the anesthesiologist. The nurse explains that anticholinergic drugs are given preoperatively to prevent which anesthesia associated complication?
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Bradycardia
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A nurse is caring for a patient who has been prescribed scopolamine hydrobromide for pre-anesthetic sedation. The drug is known to cause heat prostration during the hot summer months. What signs of heat prostration should the nurse monitor for when caring for this patient?
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Fever
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Which of the following is a cholinergic blocking drug which is available in an inhaler form for the treatment of COPD? (Choose one)
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Ipratropium (Atrovent)
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A client is using a transdermal application of scopolamine. Which of the following instructions would the nurse include when teaching the client how to use this drug?
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"Make sure the area you are using is clean, dry, and free from cuts."
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The pharmacology instructor is discussing the adverse effects of anticholinergic drugs. What drug would the instructor indicate is administered to counteract the effects of atropine poisoning?
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Physostigmine
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The physician orders glycopyrrolate (Robinul) 1 mg and morphine sulfate 10 mg IM. What disease process would contraindicate the administration of glycopyrrolate (Robinul)?
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Narrow-angle glaucoma
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When should a patient receiving propantheline (Pro-Banthine) as an adjunctive therapy for peptic ulcers be advised to take the medication? (Choose one)
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30 minutes before meals
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A patient with asthma will soon begin treatment with atropine as an adjunct to his normal drug regimen. What teaching point should the nurse include in patient education related to this new aspect of drug treatment?
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"It's possible that your eyes will take longer to adjust to bright lights."
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If a cholinergic-blocking drug is administered prior to surgery, the nurse instructs the client of which of the following? Select all that apply:
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• Dry mouth is to be expected. • Remain in bed after drug administration.
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A patient receives atropine intravenously. The nurse would expect the drug to be effective for how long?
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4 hours
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A patient is scheduled for an exploratory laparoscopy. She has been prescribed an anticholinergic agent. Why is it important to administer the anticholinergic agent in the preoperative phase?
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It will decrease respiratory secretions.
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A nurse administering a cholinergic-blocking medication to a client should monitor the client for which of the following visual adverse reactions? Select all that apply:
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• Photophobia • Mydriasis • Cycloplegia
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Your client has a preoperative order to administer atropine. You know that the rationale for this order is:
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Atropine is given preoperatively to prevent complications such as bradycardia and hypotension.
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A patient is suffering from urinary urgency and frequency. Which of the following medications will assist in treating the patient's symptoms of urinary frequency?
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Hyoscyamine (Anaspaz)
