Unit 5 Pharm Chapter 33 Flashcards
Anticholinergic agents are also called parasympatholytic agents.
A) FALSE
B) TRUE
B) TRUE
Rationale:Drugs that are used to block the effects of acetylcholine are called anticholinergic drugs. Because this action lyses, or blocks, the effects of the parasympathetic nervous system, they are also called parasympatholytic agents.
What assessments should the nurse perform when caring for a client who has received an anticholinergic agent? Select all that apply.
A) Auscultating bowel sounds
B) Assessing muscle strength
C) Monitoring urine output
D) Monitoring heart rate
E) Assessing deep tendon reflexes
A) Auscultating bowel sounds
C) Monitoring urine output
D) Monitoring heart rate
Rationale:Anticholinergic agents can slow GI activity, leading to paralytic ileus. Urinary retention is possible, so it is important to monitor the client’s urine output. Tachycardia is possible, so monitoring the heart rate would be important. Anticholinergics do not affect deep tendon reflexes or muscle strength, so assessment is not necessary
A client receives atropine intravenously. The nurse would expect the drug to be effective for how long?
A) 6 hours
B) 4 hours
C) 8 hours
D) 2 hours
B) 4 hours
Rationale:Atropine given IV has a duration of action of 4 hours.
Atropine is the most widely used anticholinergic agent.
A) TRUE
B) FALSE
A) TRUE
Rationale:Atropine is the only widely used anticholinergic drug.
The nurse is caring for a client with motion sickness who has been prescribed a scopolamine patch. What statement by the client should the nurse follow up with education?
A) “I’ll keep the patch in place for up to 3 days, but no longer than that.”
B) “I can put the patch anywhere on my skin that’s free of hair.”
C) “I might get some side effects from the patch, but I expect them to be tolerable.”
D) “I’ll use an over-the-counter motion sickness pill as well if the patch isn’t working.”
D) “I’ll use an over-the-counter motion sickness pill as well if the patch isn’t working.”
Rationale:It would be unsafe to supplement a scopolamine patch with another OTC medication for the same purpose. Scopolamine patches are changed every 3 days, and most clients tolerate the patches well. They can be placed where convenient for the client, provided the location is free of hair.
After teaching a group of students about anticholinergic agents, the instructor determines the need for additional teaching when the student’s identify what contraindication for use?
A) Toxic megacolon
B) Prostatic hypertrophy
C) Myasthenia gravis
D) Hypertension
D) Hypertension
Rationale:Anticholinergic agents should be used cautiously for clients with hypertension because of the possible additive hypertensive effects. Myasthenia gravis, toxic megacolon, and prostatic hypertrophy are contraindications for the use of anticholinergics.
The nurse, working on the postpartum unit, receives an order to administer an anticholinergic agent to one of the new mothers. Why would the nurse question this order?
A) The drug will interfere with uterine contraction.
B) The drug will increase lochia production.
C) The drug will enter the breast milk and harm the baby.
D) The drug will suppress lactation
D) The drug will suppress lactation
Rationale:The nurse will question this order because the drug will suppress lactation. Suppression of lactation is related to anticholinergic effects in the breasts and in the CNS. Crossing into the breast milk, interfering with uterine contractions, and increasing lochia production are not valid concerns and would not be something the nurse would question.
What instructions should the nurse give the client to improve drug delivery when using a transdermal patch? Select all that apply.
A) Shave the site to make it as hairless as possible.
B) Patches need not be removed if an MRI is obtained.
C) Remove the old patch and clean the site.
D) Wash the site and apply to a clean, dry area.
E) Place the patch on a new site each time.
C) Remove the old patch and clean the site.
D) Wash the site and apply to a clean, dry area.
E) Place the patch on a new site each time.
Rationale:The patch should be applied to a clean, dry, intact, and hairless area of the body. Do not shave an area of application—that could abrade the skin and lead to increased absorption. Hair may be clipped if necessary. Place the patch at a new site each time to avoid skin irritation or degradation. Be sure to remove the old patch and clean the area before putting on a new transdermal patch. It is important to remember that many transdermal systems contain an aluminized barrier that could cause an electrical charge with arcing, smoke, and severe transdermal burns if a defibrillator is discharged over it or if the client has magnetic resonance imaging (MRI).
The nurse administers atropine to an older adult. What assessment finding should the nurse attribute to the effects of this medication?
A) Disorientation to time
B) Parkinsonian tremors
C) Increased muscle tone
D) Drowsiness
A) Disorientation to time
Rationale:Atropine may cause excessive stimulation, psychosis, delirium, or disorientation. Anticholinergics decrease extrapyramidal motor activity, so they are more likely to reduce parkinsonian tremors than cause them. In most cases, anticholinergics do not cause drowsiness. Increased muscle tone is possible, but this is not a CNS effect.
Anticholinergics block acetylcholine at the muscarinic receptors.
A) FALSE
B) TRUE
B) TRUE
Rationale:The anticholinergic drugs competitively block the acetylcholine receptors at the muscarinic cholinergic receptor sites that are responsible for mediating the effects of the parasympathetic postganglionic impulses.
The nurse is interviewing a client who is to receive an anticholinergic agent. The client reports that he or she uses herbal therapies. The nurse should provide health education with regard to what supplement?
A) Gingko
B) Garlic
C) Vitamin B6
D) Turmeric
D) Turmeric
Rationale:Turmeric, when combined with anticholinergics, can increase the risk of anticholinergic effects. Vitamin B6, garlic, and gingko are not known to interact with anticholinergics.
A client has been scheduled to begin treatment with an anticholinergic medication. The nurse should assess for what potential adverse effects? Select all that apply.
A) Urinary retention
V) Blurred vision
C) Diarrhea
D) Photosensitivity
E) Dry mouth
A) Urinary retention
V) Blurred vision
D) Photosensitivity
E) Dry mouth
Rationale:Possible adverse effects of atropine include dry mouth, blurred vision, constipation, weakness, excitement, dizziness, and sensitivity to light.
What teaching point should the nurse include in a teaching plan for a client who is prescribed an anticholinergic agent?
A) Limit physical and psychological stimulation.
B) Limit fluid intake during the day.
C) Decrease fiber intake.
D) Avoid activities that require alertness.
D) Avoid activities that require alertness.
Rationale:Safety measures are important because of the possible CNS effects. There is no need to maintain a low-stimulation environment. Drinking fluids is important to maintain hydration and combat dry mouth. Constipation may occur with an anticholinergic; therefore, increased fiber intake would be appropriate.
Atropine is derived from the belladonna plant.
A) TRUE
B) FALSE
A) TRUE
Rationale:Atropine, the prototype drug, has been used for many years and is derived from the plant belladonna.
What symptom, if assessed, would the nurse not attribute to mild atropine toxicity?
A) Delirium
B) Slight slowing of heart rate
C) Absence of sweating
D) Dry mouth
A) Delirium
Rationale:Delirium is not associated with mild atropine toxicity while the other symptoms are.
