Nokea
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.
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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 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 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 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.