Nokea
A client is prescribed benztropine. The nurse would administer the drug cautiously and monitor the client closely if the client also had a diagnosis of which of the following?
- A. Hyperthyroidism
- B. Hepatic disease
- C. Renal disease
- D. Epilepsy
- E. Hypertension
Correct Answer: A,B,C,E
Rationale: Cholinergic blocking drugs, like benztropine (Cogentin), are used cautiously in clients with hypertension, GI infection, benign prostatic hypertrophy, urinary retention, hyperthyroidism, and hepatic or renal disease.
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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.
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 is assigned to care for a client with biliary colic in a health care facility. The client has been prescribed atropine. The nurse reviews the client's medical record and determines that the client should not receive this drug because the client has a history of which of the following?
- A. Hepatic disease
- B. Benign prostatic hypertrophy
- C. Myocardial infarction
- D. Urinary retention
Correct Answer: C
Rationale: The nurse should know that the use of atropine is contraindicated in clients with myocardial infarction. Other contraindications include myasthenia gravis, tachyarrhythmia, and congestive heart failure (unless bradycardia is present).
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.
The nurse should monitor clients taking which of the following medications closely for decreased efficacy if a cholinergic blocking drug is initiated.
- A. Fluconazole (Diflucan)
- B. Meperidine (Demerol)
- C. Haloperidol (Haldol)
- D. Amitriptyline (Elavil)
- E. Digoxin (Lanoxin)
Correct Answer: A,C
Rationale: The nurse should monitor clients taking fluconazole (Diflucan) and haloperidol (Haldol) closely for decreased efficacy if a cholinergic blocking drug is initiated.