A client has a nursing diagnosis of Impaired Comfort related to xerostomia from the daily administration of a cholinergic blocking drug. When assessing the client, the nurse would be alert for which of the following?
- A. Dysphagia
- B. Tooth decay
- C. Gingivitis
- D. Impeded speech
- E. Gingival hyperplasia
Correct Answer: A,D
Rationale: Dry mouth caused by daily use of cholinergic blocking drugs can result in dysphagia and impeded, difficult-to-understand speech. Tooth decay, gingivitis, and gingival hyperplasia are not associated with dry mouth.
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A nurse is administering glycopyrrolate to a client with a peptic ulcer. The nurse would assess the client for which of the following as a possible GI system adverse reaction?
- A. Diarrhea
- B. Dry mouth
- C. Constipation
- D. Nausea
- E. Dysphagia
Correct Answer: B,C,D,E
Rationale: A nurse administering glycopyrrolate to a client with a peptic ulcer should monitor the client for dry mouth, nausea, vomiting, constipation, and dysphagia.
A client comes to the clinic for a follow-up visit. It is a hot July afternoon. The client has been prescribed a cholinergic blocking drug. Which of the following would lead the nurse to suspect that the client is experiencing heat prostration?
- A. Chills
- B. Flushing
- C. Bradycardia
- D. Cool, moist skin
- E. Mental confusion
Correct Answer: B,E
Rationale: Cholinergic blocking drugs can cause decreased sweating, increasing a client's risk for heat prostration. The signs of heat prostration include fever, tachycardia, flushing, warm, dry skin, and mental confusion.
After administering a cholinergic blocking drug to a client, assessment of which of the following would lead the nurse to suspect that the client is experiencing a visual adverse reaction to the drug?
- A. Miosis
- B. Photophobia
- C. Mydriasis
- D. Diplopia
- E. Cycloplegia
Correct Answer: B,C,E
Rationale: Possible adverse effects include blurred vision, mydriasis, photophobia, cycloplegia, and increased ocular tension.
A nurse would monitor a client receiving a cholinergic blocking drug for an increased effect when the drug is administered with which of the following?
- A. Fluconazole (Diflucan)
- B. Meperidine (Demerol)
- C. Haloperidol (Haldol)
- D. Amitriptyline (Elavil)
- E. Digoxin (Lanoxin)
Correct Answer: B,D
Rationale: A nurse may notice an increased effect of the cholinergic blocking drug when it is administered with meperidine (Demerol) and amitriptyline (Elavil) because meperidine and tricyclic antidepressants increase the effect of the cholinergic blockers.
A nurse is administering a cholinergic blocking drug preoperatively to a client. What intervention should the nurse perform after administering the drug to the client?
- A. Provide cold milk to the client.
- B. Raise the side rails of the bed.
- C. Tell the client to lie completely flat in bed.
- D. Provide frequent sips of water.
Correct Answer: B
Rationale: The nurse should raise the side rails of the client's bed after administration of the drug.
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