NURSING PROCESS Bethanechol (Urecholine) Flashcards
What would you need baseline vital signs for?
For future comparison
How much should client void?
> 600 mL/d. Report if there’s a decrease
Which health problems do you need to know from the client? Why is it necessary?
If they have peptic ulcer, urinary obstruction, or asthma. Cholinergic agonists can aggravate symptoms of these conditions
What happens when large doses of cholinergic agonist drugs to the heart rate and blood pressure?
Decreased.
What side effect of urecholine is associated with blood pressure?
Orthostatic hypotension
Record fluid intake and output. What would you report regarding this?
If there is decreased urinary output because it may be related to urinary obstruction
When should cholinergic agonists be given?
1 hour before or 2 hours after meals
If client complains of gastric pain when you administer cholinergic agonist before or after meal times, what should you do?
The drug may be given with meals
Which laboratory values would you need to monitor? Will they increase or decrease?
Slightly increase. Serum amylase, lipase, aspartate aminotransferase, and bilirubin levels
Which side effects would you observe?
Gastric pain or cramping, diarrhea, increased salivary or bronchial secretions, bradycardia, and orthostatic hypotension
What would you report regarding bowel sounds?
Auscultate and report if there is a decreased or hyperactive bowel sounds
When you auscultate breath sounds, what are you looking for? Why would you hear them?
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
What is the antidote when there is a cholinergic overdose?
Have IV atropine sulfate (0.6 mg to 1.2 mg) available.
What are the early signs of cholinergic overdose?
Flushing, salivation, sweating, nausea, and abdominal cramps
Why would linens need to changed frequently?
Diaphoresis may occur (excessing perspiration)
What are the symptoms of indirect-acting drug overdose?
Muscular weakness and increased salivation
What would you teach the client to do when taking the medication?
COMPLY with the drug regimen. It is essential
What symptoms would you teach the client to report?
Profound dizziness or a decrease in heart rate below 60 beats/min
What would you teach to the client to avoid orthostatic hypotension?
Arrise slowly from a lying position to avoid dizziness.
What would you remind the client regarding excessive salivation?
Maintain oral hygiene
What would you teach the client to report regarding his changes in breathing?
Report if there’s a difficulty in breathing which may result from respiratory distress
What would you direct to the client when taking indirect-acting cholinergic agonist drugs (e.g., for myasthenia gravis)?
To take the drug on time and always evaluate muscle strength so the healthcare providers know if the drug regimen is working
When offering prescriptions or pamphlets to Asians and Pacific Islanders, what do you need to do?
Use both hands to show respect
What would you evaluate?
Determine effectiveness of the drug. Evaluate the stability of client’s vital signs and note side effects or adverse reactions