Anticholinergic Drugs Flashcards
The nurse is about to administer a STAT dose of atropine sulphate to a patient who is experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the nurse monitors the patient closely for which adverse effect?
a. Tachycardia
b. Bradycardia
c. Ectopic beats
d. Cardiac standstill
ANS: A
Cardiovascular effects of cholinergic blockers include an increased heart rate and dysrhythmias. One indication for use is sinus bradycardia accompanied by hemodynamic compromise.
How long can a scopolamine patch prevent motion sickness?
a. 1 day
b. 2 days
c. 3 days
d. 4 days
ANS: C
A scopolamine patch can prevent motion sickness for 3 days.
Which condition is appropriate for treatment with a cholinergic-blocking drug?
a. Glaucoma
b. Myasthenia gravis
c. Irritable bowel disease
d. Genitourinary obstruction
ANS: C
Cholinergic-blocking drugs may be used to treat irritable bowel disease. Glaucoma, myasthenia gravis, and genitourinary obstruction are contraindications to the use of these drugs.
Which medication is the antidote to severe cases of atropine overdose?
a. atenolol (Tenormin®)
b. bethanechol
c. scopolamine patch
d. physostigmine
ANS: D
Physostigmine is the antidote to an atropine overdose in clients who show extreme delirium or agitation and who could injure themselves.
A 72-year-old male has a new prescription for an anticholinergic. He is an active man and enjoys outdoor activities such as hiking, golfing, and doing yard work. During a teaching session about his drug therapy, the nurse should emphasize that
a. drowsiness may interfere with his outdoor activities.
b. increased salivation may occur during exercise and outdoor activities.
c. fluid volume deficits may occur as a result of an increased incidence of diarrhea.
d. he should take measures to reduce the occurrence of heat stroke during his
activities.
ANS: D
Older adult patients who take an anticholinergic should be reminded that they are at a greater risk for suffering a heat stroke because of decreased sweating and loss of normal heat-regulating mechanisms.
When administering an anticholinergic drug, the nurse expects the patient will experience which adverse effect?
a. Excessive urination
b. Diaphoresis
c. Dry mouth
d. Pupil constriction
ANS: C
Anticholinergic drugs frequently cause dry mouth, blurred vision, constipation, and urinary retention.
For what is oxybutynin (Ditropan®) used?
a. To treat symptoms associated with irritable bowel disease
b. For induction of mydriasis
c. As an antispasmodic for neurogenic bladder
d. For reduction of secretions preoperatively
ANS: C
Oxybutynin is used as an antispasmodic for the treatment of neurogenic and overactive bladder conditions. Irritable bowel disease is not an indication for oxybutynin, and the induction of mydriasis and the preoperative reduction of secretions are not uses for oxybutynin.
What is the advantage of using tolterodine (Detrol®) for urinary incontinence as compared with other drugs?
a. Drowsiness is not usually a problem.
b. Tolterodine may also be used for urinary retention.
c. Tolterodine can be used in patients with narrow-angle glaucoma.
d. The incidence of dry mouth is much lower with tolterodine.
ANS: D
Tolterodine is contraindicated if narrow-angle glaucoma or urinary retention is present, and drowsiness may occur as therapy is started. However, compared with other drugs, when using tolterodine, the incidence of dry mouth is much lower.
The nurse working in a preoperative holding unit anticipates an order to give which anticholinergic medication to a newly admitted patient?
a. dicyclomine (Bentylol®)
b. tolterodine (Detrol)
c. donepezil
d. glycopyrrolate
ANS: D
Glycopyrrolate is an anticholinergic drug that can be used to control secretions during surgery.
Solifenacin succinate (Vesicare®) is contraindicated for patients with which condition?
a. Glaucoma and severe constipation
b. Urinary retention and diarrhea
c. Genitourinary tract problems and dry mouth
d. Gastrointestinal problems and blurred vision
ANS: A
Solifenacin succinate is contraindicated for patients with glaucoma, certain gastrointestinal and genitourinary tract problems, severe constipation, and urinary retention. Diarrhea, dry mouth, and blurred vision are adverse effects of solifenacin succinate.
Atropine is appropriate for which patients? (Select all that apply.)
a. A patient who has suddenly developed symptomatic bradycardia, with a heart rate
of 32 beats per minute
b. A patient who has suddenly developed symptomatic tachycardia, with a heart rate
of 180 beats per minute
c. A patient with severe narrow-angle glaucoma
d. A patient who requires preoperative reduction of salivary and gastrointestinal
secretions myasthenia gravis
e. A patient newly diagnosed with myasthenia gravis
f. A patient with severe diarrhea
ANS: A, D, F
Anticholinergic drugs are used to treat symptomatic bradycardia and certain other cardiac conditions, to preoperatively control secretions during surgery, and to decrease intestinal motility. Symptomatic tachycardia, narrow-angle glaucoma, the reduction of salivary and gastrointestinal secretions, and myasthenia gravis are contraindications to the use of atropine.
DIF: Cognitive Level: Application
