Questions and Answers
Which of the following are side effects of Bethanechol chloride? (Select all that apply)
Which statement by the patient indicates that the nurse’s teaching is effective regarding adrenergic agonist medication?
Which assessment finding would the nurse expect in a patient taking a selective beta1-receptor blocker?
Which assessment finding would indicate that propranolol is having a therapeutic effect?
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Which description of anticholinergic medications is accurate?
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Which physiologic effect would be unexpected with the administration of cholinergic agonists?
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Which clinical presentation is suggestive of complications of anticholinergic drugs? Select all that apply.
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Which assessment finding would prompt the nurse to hold the medication and contact the health care provider if the nurse is preparing to administer an indirect-acting cholinergic agonist?
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Which statement best describes the rationale behind the nurse instructing a patient who has received atropine eye drops to remain in a darkened room or wear sunglasses?
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Which body part is controlled and regulated by the autonomic nervous system? Select all that apply.
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Which adverse reaction would the nurse monitor for in a patient taking bethanechol for the treatment of urinary retention?
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Which assessment finding is a clinical indicator of parasympathetic nervous system stimulation?
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Which condition in a patient’s history would put the patient at an increased risk for adverse effects after the administration of a beta blocker?
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Which statement(s) describes how the therapeutic effect of atenolol differs from the therapeutic action of prazosin in decreasing blood pressure? Select all that apply.
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Which response is a result of sympathetic nervous system stimulation?
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Which side effect will the nurse include in an education session about bethanechol for the treatment of urinary retention?
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Study Notes
Anticholinergic Medications
- Anticholinergic drugs can lead to urinary retention by relaxing the bladder detrusor muscle and increasing internal sphincter constriction.
- They inhibit the parasympathetic nervous system, decreasing salivation and increasing heart rate at higher doses.
- Commonly prescribed for reducing muscle rigidity and tremors in Parkinson's disease.
Cholinergic Agonists
- Administering cholinergic agonists can lead to increased peristalsis, bronchial secretions, and pupillary constriction.
- An unexpected effect would be increased blood pressure, which actually decreases due to vasodilation.
Complications from Anticholinergic Drugs
- Complications include dry mouth, tachycardia, and blurred vision due to cholinergic receptor blockage.
- Diarrhea and bronchospasm are not associated with anticholinergic complications.
Assessment Findings
- A pulse rate below 60 beats per minute prompts the nurse to hold indirect-acting cholinergic agonists and contact the healthcare provider.
- Symptoms of parasympathetic nervous system stimulation include slowing of heart rate and bladder emptying, not urine retention.
Atropine Use in Eye Exams
- Atropine induces mydriasis (pupil dilation), affecting the ability to adapt to bright light, necessitating sunglasses or a dark room.
- It causes relaxation of ciliary muscles, leading to blurred vision and potential elevation in intraocular pressure.
Autonomic Nervous System Control
- The autonomic nervous system regulates involuntary muscles and glands including the eyes, heart, urinary bladder, respiratory and gastrointestinal systems.
- The skeletal system is controlled voluntarily, not by the autonomic nervous system.
Adverse Effects of Medications
- Bethanechol may cause bronchospasms, hypotension, and gastrointestinal upset; it is important to monitor for these effects.
- In patients with diabetes who use insulin, beta blockers may increase the risk of hypoglycemia by masking symptoms.
Differences Between Atenolol and Prazosin
- Atenolol (beta1 antagonist) decreases heart rate and cardiac output, while prazosin (alpha1 antagonist) primarily causes vasodilation.
- Atenolol does not produce vasodilation; its effects are focused on heart rhythm and strength of contraction.
Sympathetic Nervous System Stimulation
- Stimulation leads to pupillary dilation, whereas parasympathetic stimulation results in bronchial constriction and decreased heart rate.
Side Effects and Education for Bethanechol
- Common side effects of bethanechol include nausea, abdominal cramps, and urinary urgency.
- It does not cause constipation; instead, it can lead to diarrhea and urinary frequency.
Effective Patient Teaching
- Patient understanding of medication administration is assessed through their ability to articulate the effects and purposes of adrenergic agonist medications.### Medication Considerations
- Limit fluid intake is not recommended; instead, increase fluids to prevent constipation.
- Caffeine from coffee and chocolate should be avoided due to potential irritation of the cardiac and central nervous systems.
- Moderate consumption of red wine with meals is generally considered acceptable but should be approached with caution due to possible hypotension effects.
Selective Beta1-Receptor Blockers
- Expect a decreased heart rate in patients taking selective beta1-receptor blockers, with a pulse rate around 62 beats per minute.
- Wheezing is not expected; its presence indicates bronchoconstriction, which is not a typical effect of beta1 blockade.
- A regular apical pulse is anticipated, and a bounding radial pulse is inconsistent with decreased contractility.
Propranolol Therapeutic Effects
- Propranolol acts as a nonselective beta-blocker, affecting both beta1 and beta2 receptors.
- Therapeutic goal includes managing hypertension; a blood pressure reading of 130/75 mm Hg reflects a positive response to the medication.
- Clear lung fields indicate no respiratory side effects, essential for patients on nonselective beta-blockers.
- Strong peripheral pulses may indicate good circulation but do not directly correlate with propranolol's pharmacological effects.
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Description
This quiz covers the key concepts of anticholinergic and cholinergic medications, their mechanisms of action, and potential complications. Assess your understanding of how these drugs affect bodily functions and their applications in medical treatments. Perfect for students of pharmacology or nursing.
