Nokea
A client has been prescribed pyridostigmine for myasthenia gravis. The nurse would be alert for the development of which of the following?
- A. Seizure disorder
- B. Reduction of visual acuity
- C. Abdominal discomfort
- D. Cardiac arrhythmias
Correct Answer: D
Rationale: The nurse should monitor for cardiac arrhythmias as a general adverse reaction in the client. Seizure disorder, reduction of visual acuity, and abdominal discomfort are not pyridostigmine-related adverse reactions. Reduction of visual acuity is related to topical ophthalmics. When the client is receiving bethanechol chloride for urinary retention, the nurse needs to examine for abdominal discomfort, which is an adverse reaction of bethanechol chloride and not pyridostigmine.
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The nurse would assess the client closely if the client has a history of which of the following?
- A. Diabetes
- B. Hypertension
- C. Tachycardia
- D. Epilepsy
- E. Megacolon
Correct Answer: B,D
Rationale: Cholinergic drugs, like ambenonium, are used cautiously in clients with hypertension, epilepsy, cardiac arrhythmias, bradycardia, recent coronary occlusion, and megacolon.
A nurse would be alert for an increase in cholinergic effects if a client who is prescribed a cholinergic drug is also receiving which medication?
- A. Prednisone
- B. Oxycodone
- C. Diclofenac
- D. Dexamethasone
- E. Ibuprofen
Correct Answer: A,D
Rationale: Cholinergic drugs administered concomitantly with corticosteroids, like prednisone and dexamethasone, can result in increased adverse effects of the cholinergic drug.
The nurse administers a prescribed oral dose of bethanechol to a client with urinary retention at 9:30 a.m. The nurse would notify the primary health care provider if the client has not voided by which time?
- A. 9:45 a.m.
- B. 10 a.m.
- C. 10:30 a.m.
- D. 11 a.m.
Correct Answer: D
Rationale: When bethanechol is administered orally, the client should void within 30 to 90 minutes. Therefore, if the client has not yet voided by 11 a.m., the nurse should notify the primary health care provider.
A nurse is caring for a client with myasthenia gravis at a health care facility. The client is receiving ambenonium. The nurse suspects that the dosage is insufficient based on assessment of which of the following?
- A. Clenching of the jaw
- B. Muscle spasms
- C. Difficulty breathing
- D. Abdominal cramping
Correct Answer: C
Rationale: The nurse should monitor for difficulty breathing as a symptom of drug underdosage. Clenching of the jaw and muscle spasms are symptoms of drug overdosage. Abdominal cramping may occur in the client who is receiving guanidine.
After teaching a group of nursing students about cholinergic drugs, the instructor determines a need for additional teaching when the students identify which drug as being administered orally?
- A. Ambenonium
- B. Bethanechol
- C. Pyndostigmine
- D. Edrophonium
Correct Answer: D
Rationale: Edrophonium is a cholinergic drug that is administered intravenously. Ambenonium, bethanechol, and pyridostigmine are administered orally.