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A nurse is reviewing the medical record of a client who is to receive a cholinergic blocking drug. Which of the following would the nurse identify, if found, as contraindicating the use of the drug?
- A. Pancreatitis
- B. Diabetes
- C. Asthma
- D. Glaucoma
- E. Myocardial infarction
Correct Answer: D,E
Rationale: The use of a cholinergic blocking drug is contraindicated in clients with known hypersensitivity to the drugs, glaucoma, myasthenia gravis, tachyarrhythmias, myocardial infarction, and congestive heart failure (unless bradycardia is present).
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A nurse identifies a nursing diagnosis of Constipation related to the effects of the prescribed cholinergic blocking drug. Which of the following would the nurse expect to include in the client's plan of care?
- A. Encuring the intake of a diet high in fiber.
- B. Decreasing the dosage of the cholinergic blocking medication
- C. Increasing client's fluid intake to at least 2000 mL daily
- D. Withholding the drug until the client resumes usual bowel pattern
- E. Encouraging ambulation and exercise as appropriate
Correct Answer: A,C,E
Rationale: Appropriate interventions include encouraging a high-fiber diet, increasing fluid intake, and encouraging ambulation and exercise. It is not the nurse's decision to decrease the dosage. Withholding the drug until the client's bowel patterns return would be inappropriate.
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 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.
A nurse suspects that a client who has received scopolamine is experiencing an idiosyncratic reaction to the drug based on assessment of which of the following?
- A. Drowsiness
- B. Restlessness
- C. Hypotension
- D. Insomnia
- E. Dry mouth
Correct Answer: B,D
Rationale: Excitement, delirium, restlessness, and insomnia represent idiosyncratic reactions to scopolamine.
A nurse withholds a cholinergic blocking drug prescribed for an older adult client based on which assessment finding?
- A. Excitement
- B. Mental confusion
- C. Urinary retention
- D. Drowsiness
- E. Agitation
Correct Answer: A,B,C,D,E
Rationale: A nurse should withhold a cholinergic blocking drug from an older adult client who is excited, agitated, mentally confused, drowsy, or experiencing urinary retention or other adverse effects.