NURSING PROCESS Bethanechol (Urecholine)

Question 1

What would you need baseline vital signs for?

Answer 1

For future comparison

Question 2

How much should client void?

Answer 2

> 600 mL/d. Report if there’s a decrease

Question 3

Which health problems do you need to know from the client? Why is it necessary?

Answer 3

If they have peptic ulcer, urinary obstruction, or asthma. Cholinergic agonists can aggravate symptoms of these conditions

Question 4

What happens when large doses of cholinergic agonist drugs to the heart rate and blood pressure?

Answer 4

Decreased.

Question 5

What side effect of urecholine is associated with blood pressure?

Answer 5

Orthostatic hypotension

Question 6

Record fluid intake and output. What would you report regarding this?

Answer 6

If there is decreased urinary output because it may be related to urinary obstruction

Question 7

When should cholinergic agonists be given?

Answer 7

1 hour before or 2 hours after meals

Question 8

If client complains of gastric pain when you administer cholinergic agonist before or after meal times, what should you do?

Answer 8

The drug may be given with meals

Question 9

Which laboratory values would you need to monitor? Will they increase or decrease?

Answer 9

Slightly increase. Serum amylase, lipase, aspartate aminotransferase, and bilirubin levels

Question 10

Which side effects would you observe?

Answer 10

Gastric pain or cramping, diarrhea, increased salivary or bronchial secretions, bradycardia, and orthostatic hypotension

Question 11

What would you report regarding bowel sounds?

Answer 11

Auscultate and report if there is a decreased or hyperactive bowel sounds

Question 12

When you auscultate breath sounds, what are you looking for? Why would you hear them?

Answer 12

You will hear rales (cracking sounds from fluid congestion in lung tissue) or rhonchi (rough sounds resulting from mucous secretions in lung tissue). Cholinergic agonists can increase bronchial secretions

Question 13

What is the antidote when there is a cholinergic overdose?

Answer 13

Have IV atropine sulfate (0.6 mg to 1.2 mg) available.

Question 14

What are the early signs of cholinergic overdose?

Answer 14

Flushing, salivation, sweating, nausea, and abdominal cramps

Question 15

Why would linens need to changed frequently?

Answer 15

Diaphoresis may occur (excessing perspiration)

Question 16

What are the symptoms of indirect-acting drug overdose?

Answer 16

Muscular weakness and increased salivation

Question 17

What would you teach the client to do when taking the medication?

Answer 17

COMPLY with the drug regimen. It is essential

Question 18

What symptoms would you teach the client to report?

Answer 18

Profound dizziness or a decrease in heart rate below 60 beats/min

Question 19

What would you teach to the client to avoid orthostatic hypotension?

Answer 19

Arrise slowly from a lying position to avoid dizziness.

Question 20

What would you remind the client regarding excessive salivation?

Answer 20

Maintain oral hygiene

Question 21

What would you teach the client to report regarding his changes in breathing?

Answer 21

Report if there’s a difficulty in breathing which may result from respiratory distress

Question 22

What would you direct to the client when taking indirect-acting cholinergic agonist drugs (e.g., for myasthenia gravis)?

Answer 22

To take the drug on time and always evaluate muscle strength so the healthcare providers know if the drug regimen is working

Question 23

When offering prescriptions or pamphlets to Asians and Pacific Islanders, what do you need to do?

Answer 23

Use both hands to show respect

Question 24

What would you evaluate?

Answer 24

Determine effectiveness of the drug. Evaluate the stability of client’s vital signs and note side effects or adverse reactions