NURS 3210 Module 2 ALG
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Questions and Answers

What is the primary goal of donepezil in managing Alzheimer's disease?

to stabilize or improve cognitive function

Why is it essential to emphasize the dosing schedule and duration of action when teaching a patient about pyridostigmine (Mestinon)?

because pyridostigmine requires multiple doses throughout the day to maintain muscle tone and strength and prevent symptoms of myasthenia gravis from returning

What is a contraindication to the use of scopolamine patches?

increased intraocular pressure, urinary retention, paralytic ileus, difficulty urinating, and exacerbating signs and symptoms of myasthenia gravis

Why is patient education on medication adherence crucial when using pyridostigmine (Mestinon)?

<p>to prevent symptoms of myasthenia gravis from returning</p> Signup and view all the answers

What is a potential side effect of transdermal scopolamine?

<p>drowsiness</p> Signup and view all the answers

What is a potential drug interaction to consider when using scopolamine?

<p>worsening symptoms of myasthenia gravis</p> Signup and view all the answers

Why is it important to assess for contraindications before using scopolamine?

<p>to prevent adverse effects such as increased intraocular pressure, urinary retention, and difficulty urinating</p> Signup and view all the answers

What is the key aspect of patient education on medication use when using pyridostigmine (Mestinon)?

<p>emphasizing the dosing schedule and duration of action</p> Signup and view all the answers

Why should J decline the champagne offered by the waiter?

<p>Alcohol may increase drowsiness and dizziness while taking scopolamine.</p> Signup and view all the answers

What did L notice about J's eyes after applying the transdermal scopolamine patch?

<p>J's pupils were larger than normal, indicating dilation.</p> Signup and view all the answers

Is it a good idea for J to remove the patch and store it for later use?

<p>No, it's not a good idea. The patch can become contaminated, lose adhesion, and reduce effectiveness.</p> Signup and view all the answers

What is the importance of patient education on medication use?

<p>It ensures patients understand dosage, timing, and potential interactions to achieve optimal outcomes.</p> Signup and view all the answers

What is a contraindication to the use of scopolamine?

<p>None mentioned in the provided text, but generally, contraindications may include glaucoma, urinary retention, or hypersensitivity.</p> Signup and view all the answers

How does scopolamine interact with alcohol?

<p>Alcohol may increase drowsiness and dizziness while taking scopolamine.</p> Signup and view all the answers

What should J prioritize to ensure safe and effective treatment with scopolamine?

<p>Following patient education, dosage, timing, and medication adherence.</p> Signup and view all the answers

What is the importance of monitoring side effects when using transdermal scopolamine?

<p>It helps identify and manage potential side effects, such as pupillary dilation, to ensure patient safety.</p> Signup and view all the answers

What is the nurse's priority when the patient states that she will quit taking propranolol after a month or two if it doesn't work?

<p>To assess the patient's understanding and knowledge of the medication, expectations, and the need for medication adherence and consistency.</p> Signup and view all the answers

Why is fall prevention a high-priority issue for the 73-year-old man taking tamsulosin (Flomax) for BPH?

<p>Because tamsulosin can cause orthostatic hypotension, which can lead to dizziness, lightheadedness, and syncope, increasing the risk of falls.</p> Signup and view all the answers

What is a crucial piece of information that the patient taking tamsulosin (Flomax) should inform all healthcare providers about?

<p>That they are taking tamsulosin, especially before any type of surgery.</p> Signup and view all the answers

What should the patient taking tamsulosin (Flomax) avoid to prevent postural hypotension?

<p>Alcohol intake, excessive exercise, exposure to hot climates, and use of saunas, hot tubs, and heated showers or baths.</p> Signup and view all the answers

What is the primary reason for the nurse to emphasize fall prevention strategies with the patient taking tamsulosin (Flomax)?

<p>To minimize the risk of injury due to orthostatic hypotension.</p> Signup and view all the answers

What is a potential side effect of tamsulosin (Flomax) that the patient should be aware of?

<p>Orthostatic hypotension, which can cause dizziness, lightheadedness, and syncope.</p> Signup and view all the answers

Why is patient education on medication use crucial for the patient taking propranolol (Inderal)?

<p>To ensure medication adherence and consistency in managing diagnosed signs and symptoms.</p> Signup and view all the answers

What is a key factor in promoting medication adherence in patients taking propranolol (Inderal)?

<p>Patient understanding and knowledge of the medication, expectations, and the need for medication adherence and consistency.</p> Signup and view all the answers

What is the primary mechanism of action of donepezil in treating Alzheimer's disease, and how does it impact the patient's symptoms?

<p>Donepezil is an acetylcholinesterase inhibitor that increases the levels of acetylcholine in the brain, thereby improving memory and reducing confusion in patients with Alzheimer's disease.</p> Signup and view all the answers

Compare and contrast the causes of myasthenic crisis and cholinergic crisis, and describe their distinct presentations.

<p>Myasthenic crisis is caused by a sudden exacerbation of myasthenia gravis, leading to decreased acetylcholine receptors, whereas cholinergic crisis is caused by overstimulation of nicotinic and muscarinic receptors due to excessive acetylcholine accumulation. Myasthenic crisis presents with severe muscle weakness, while cholinergic crisis presents with excessive salivation, lacrimation, and sweating.</p> Signup and view all the answers

How does the treatment of myasthenic crisis differ from that of cholinergic crisis, and what medications are commonly used in each case?

<p>Myasthenic crisis treatment focuses on supportive care, including mechanical ventilation and IV immunoglobulins, whereas cholinergic crisis treatment involves administering atropine to impede overactive cholinergic stimulation.</p> Signup and view all the answers

What is the importance of patient education on medication adherence when using medications like pyridostigmine (Mestinon), and what potential consequences may arise from non-adherence?

<p>Patient education on medication adherence is crucial to ensure that patients take their medications as prescribed, as non-adherence can lead to treatment failure and worsening of symptoms.</p> Signup and view all the answers

What are the potential side effects of transdermal scopolamine, and how can they be managed?

<p>Common side effects of transdermal scopolamine include dry mouth, dizziness, and blurred vision. These effects can be managed by adjusting the dose, using concomitant medications, and monitoring the patient for adverse effects.</p> Signup and view all the answers

Describe a potential drug interaction to consider when using scopolamine, and how it may impact treatment outcomes.

<p>Scopolamine can interact with alcohol, leading to increased central nervous system depression and impairment of cognitive function.</p> Signup and view all the answers

What is a contraindication to the use of scopolamine, and how should patients be assessed before initiating treatment?

<p>A contraindication to scopolamine use is narrow-angle glaucoma. Patients should be assessed for contraindications, including glaucoma, before initiating scopolamine therapy.</p> Signup and view all the answers

How does patient education on medication use impact treatment outcomes, and what key aspects should be emphasized during education?

<p>Patient education on medication use is crucial for improving treatment adherence and outcomes. Key aspects to emphasize include dosing schedules, potential side effects, and potential drug interactions.</p> Signup and view all the answers

What is the primary mechanism of action of beta-2 adrenergic agonists, such as albuterol, in bronchodilation?

<p>Stimulation of beta-2 adrenergic receptors in the lungs, leading to relaxation of airway smooth muscle and increased airflow.</p> Signup and view all the answers

How do anticholinergic medications, such as atropine, affect the body?

<p>They block the action of acetylcholine, a neurotransmitter, at muscarinic receptors, leading to decreased parasympathetic activity and increased sympathetic activity.</p> Signup and view all the answers

What is the primary therapeutic effect of dopamine, a neurotransmitter, in the body?

<p>It plays a crucial role in regulating movement, motivation, and reward processing, and is also involved in the regulation of blood pressure and kidney function.</p> Signup and view all the answers

What is the primary mechanism of action of cholinergic medications, such as donepezil, in the treatment of Alzheimer's disease?

<p>They increase the levels of acetylcholine in the brain, which can improve memory and cognitive function.</p> Signup and view all the answers

What is the potential side effect of transdermal scopolamine, and how can it be managed?

<p>Dry mouth, and it can be managed by using sugar-free gum or candy to stimulate saliva production, or by using oral moisturizers.</p> Signup and view all the answers

What is a potential drug interaction to consider when using scopolamine, and how can it be managed?

<p>Interaction with anticholinergic medications, which can increase the risk of anticholinergic side effects, and it can be managed by closely monitoring for side effects and adjusting medication doses as needed.</p> Signup and view all the answers

What is a contraindication to the use of scopolamine, and how can it be managed?

<p>Narrow-angle glaucoma, and it can be managed by avoiding the use of scopolamine in patients with this condition.</p> Signup and view all the answers

Why is patient education on medication use crucial when using pyridostigmine, and how can it be facilitated?

<p>It is crucial to ensure that patients understand the dosing schedule and duration of action, and it can be facilitated by using teach-back methods and providing written instructions.</p> Signup and view all the answers

Study Notes

Alzheimer's Disease and Donepezil

  • Donepezil is used to manage signs and symptoms of Alzheimer's disease, but significant improvement is not always observed.
  • It helps stabilize or improve cognitive function, and the response to the medication can vary from person to person.

Pyridostigmine (Mestinon) and Myasthenia Gravis

  • Pyridostigmine is used to treat myasthenia gravis, a disease that affects muscle tone and strength.
  • The priority patient education for pyridostigmine is to emphasize the dosing schedule and duration of action.
  • The medication requires multiple doses throughout the day to prevent symptoms of myasthenia gravis from returning.
  • The nurse will educate on the importance of medication adherence, dosage times, and possible side effects.

Scopolamine Patch and Contraindications

  • Contraindications to the use of scopolamine patch include:
    • Increased intraocular pressure
    • Worsening urinary retention
    • Exacerbating conditions similar to paralytic ileus
    • Difficulty urinating
    • Exacerbating signs and symptoms of myasthenia gravis
  • The nurse will assess for contraindications to scopolamine before the patient starts using the patch.

Physiologic Responses of SNS Stimulation and Blockade

  • Stimulation of the sympathetic nervous system (SNS) can lead to:
    • Increased heart rate
    • Increased blood pressure
    • Vasoconstriction
    • Increased respiration
    • Increased glucose release
  • Blockade of the SNS can lead to:
    • Decreased heart rate
    • Decreased blood pressure
    • Vasodilation
    • Decreased respiration
    • Decreased glucose release

Propranolol (Inderal) and Tachycardia

  • Propranolol is used to control tachycardia and hypertension.
  • The nurse's priority is to assess the patient's understanding and knowledge of the medication, expectations, and the need for medication adherence.

Tamsulosin (Flomax) and BPH

  • Tamsulosin is used to treat benign prostatic hyperplasia (BPH).
  • The nurse's priority is to emphasize fall prevention strategies due to the risk of orthostatic hypotension.
  • Patients taking tamsulosin should inform all healthcare providers of their medication regimen, especially before surgery.

Dopamine Infusion and Case Study

  • Dopamine is a neurotransmitter that can stimulate alpha-1, beta-1, and beta-2 receptors.
  • The nurse's priority is to assess the patient's understanding and knowledge of the medication, expectations, and the need for medication adherence.

Myasthenic Crisis vs. Cholinergic Crisis

  • Myasthenic crisis:
    • Caused by sudden exacerbation of myasthenia gravis
    • Significant decrease in functional acetylcholine receptors at the neuromuscular junction
    • Presentation: severe muscle weakness affecting different muscle groups
    • Treatment: supportive care to ensure adequate ventilation and oxygenation, possibly mechanical ventilation or IV immunoglobulins
  • Cholinergic crisis:
    • Caused by overstimulation of nicotinic and muscarinic receptors at the neuromuscular junction
    • Presentation: excessive cholinergic stimulation, increased salivation, lacrimal fluid, and sweating
    • Treatment: focused on impeding the overactive cholinergic stimulation, using atropine administration, a muscarinic antagonist.

Alzheimer's Disease and Donepezil

  • Donepezil treats memory loss and confusion in people with Alzheimer's disease.
  • It may be started after diagnostic tests are performed, but it does not stop the progression of Alzheimer's disease.

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This quiz assesses understanding of Donepezil, a medication used to manage Alzheimer's disease symptoms and its effects on cognitive function.

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