Nokea
A nurse is administering cholinergic eye drops to a client. The nurse would be alert for which of the following as a possible adverse reaction?
- A. Nausea
- B. Headache
- C. Nasal congestion
- D. Decreased visual acuity
- E. Decreased auditory acuity
Correct Answer: B,D
Rationale: Cholinergic eye drops are used to treat glaucoma. Topical administration usually produces few adverse reactions, but a temporary reduction of visual acuity and headache may occur.
You may also like to solve these questions
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 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.
After teaching a group of nursing students about the parasympathetic nervous system, the instructor determines that the teaching was successful when the students identify which of the following as an action?
- A. Decreased salivary gland production
- B. Vasodilation
- C. Increased peristalsis
- D. Bronchodilation
- E. Pupillary constriction
Correct Answer: B,C,E
Rationale: Stimulation of the parasympathetic nervous system results in the opposite reactions to those triggered by the adrenergic system: blood vessels dilate, sending blood to the gastrointestinal (GI) tract; secretions and peristalsis are activated and salivary glands increase production; the heart slows and pulmonary bronchioles constrict; the smooth muscle of the bladder contracts; and the pupils of the eyes constrict.
When conducting client teaching with a client and his family about the prescribed cholinergic therapy for myasthenia gravis, which of the following would be most important to include?
- A. How to adjust dosage
- B. Indications of drug underdosage
- C. The need to monitor blood glucose levels
- D. How to keep a record of response to therapy
- E. The need to wear medical identification
Correct Answer: A,B,D,E
Rationale: Client and family teaching should include signs and symptoms associated with underand overdosage, instructions on how to adjust the dosage up or down, how to keep a record of the response to therapy, and the importance of wearing medical identification. There is no need for the client and family to monitor blood glucose levels.
A client with myasthenia gravis who is prescribed pyridostigmine comes to the emergency department complaining of abdominal cramping, excessive diarrhea, and severe muscle weakness. The nurse would suspect which of the following?
- A. Underdosage of the drug
- B. Tolerance to the drug
- C. Cholinergic crisis
- D. Underlying infection
Correct Answer: C
Rationale: Cholinergic crisis (cholinergic drug toxicity) symptoms include severe abdominal cramping; diarrhea; excessive salivation; muscle weakness, rigidity, and spasms; and clenching of the jaw. Signs of drug underdosage are signs of the disease itself, namely, rapid fatigability of the muscles, drooping of the eyelids, and difficulty breathing. Tolerance would be indicated by a reduction in the adverse reactions to the drug that the client was experiencing. There is no information to suggest that the client has an underlying infection.