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When describing the different cholinergic blockers, which of the following would a nursing instructor include as affecting only the muscarinic receptors?
- A. Darifenacin (Enablex)
- B. Oxybutynin (Ditropan)
- C. Benztropine (Cogentin)
- D. Biperiden (Akineton)
- E. Tolterodine (Detrol)
Correct Answer: A,B,E
Rationale: Antispasmodic cholinergic blocking drugs, like darifenacin (Enablex), oxybutynin (Ditropan), and tolterodine (Detrol), only affect muscarinic receptors in the parasympathetic nervous system and have no effect on nicotinic receptors.
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A nurse is providing care to a client with COPD. The nurse anticipates that which of the following would be appropriate to be prescribed for this client?
- A. Darifenacin (Enablex)
- B. Ipratropium (Atrovent)
- C. Benztropine (Cogentin)
- D. Biperiden (Akineton)
- E. Tiotropium (Spiriva)
Correct Answer: B,E
Rationale: Ipratropium (Atrovent) and tiotropium (Spiriva) are inhaled cholinergic blocking drugs used in the treatment of chronic obstructive pulmonary disease (COPD).
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.
If a cholinergic blocking drug is administered prior to surgery, which of the following would be most appropriate?
- A. Encourage the client to void after the drug is given.
- B. Tell the client that his mouth may feel dry.
- C. Allow the client to take sips of fluids.
- D. Have the client remain in bed after drug administration.
- E. Encourage the client to sit in the chair for about 30 minutes.
Correct Answer: B,D
Rationale: If a cholinergic blocking drug is administered prior to surgery, the nurse instructs the client to void before the drug is given, that an extremely dry mouth is normal but that no fluid should be ingested, and that the client should remain in bed, not sit in a chair.
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.
A nurse is caring for a client admitted to the health care facility. The client is receiving a cholinergic blocking drug as treatment for bladder overactivity. Which intervention would be most appropriate for the nurse to include as part of the client's ongoing assessment?
- A. Assessment of the client's medical history
- B. Evaluation of symptoms related to the client's diagnosis
- C. Monitoring of the client's vital signs every 24 hours
- D. Observation for behavioral changes in the client
Correct Answer: B
Rationale: The nurse should evaluate the symptoms and complaints related to the client's diagnosis during the ongoing assessment of the treatment.