A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?

STAT administration of atropine

administration of activated charcoal

hemodialysis

intravenous administration of pseudoephedrine

Answer and Explanation

The Correct Answer is A

A) STAT administration of atropine:
This is the correct answer. Atropine is a cholinergic antagonist that can increase heart rate by blocking the action of acetylcholine on cardiac muscarinic receptors. In cases of severe bradycardia, especially if associated with symptoms such as dizziness, syncope, or hypotension, atropine is often administered to increase heart rate and improve cardiac output. The dose of atropine and frequency of administration depend on the severity of bradycardia and the clinical response.

B) Administration of activated charcoal:
Activated charcoal is used in cases of overdose or poisoning to absorb ingested toxins and prevent their absorption into the bloodstream. However, in this scenario, where the primary concern is bradycardia resulting from cholinesterase inhibitor (donepezil) toxicity, activated charcoal would not be effective in reversing the bradycardic effects of the medication.

C) Hemodialysis:
Hemodialysis is a renal replacement therapy used to remove toxins and waste products from the blood in individuals with kidney failure. While hemodialysis may be indicated in cases of severe drug overdose or poisoning to enhance toxin elimination, it is not typically used as a first-line intervention for bradycardia associated with cholinesterase inhibitor toxicity.

D) Intravenous administration of pseudoephedrine:
Pseudoephedrine is a sympathomimetic drug that acts as a vasoconstrictor and can increase heart rate and blood pressure. While it may be used to treat bradycardia in some cases, such as severe symptomatic bradycardia unresponsive to atropine, it is not the first-line treatment for cholinesterase inhibitor toxicity-induced bradycardia. Atropine is preferred due to its direct antagonism of muscarinic receptors in the heart.

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Correct Answer is C

Explanation

A) Migraines:
Pseudoephedrine is not contraindicated for migraines. In fact, it is sometimes used in combination with other medications to alleviate symptoms of sinus congestion associated with migraines.

B) Diverticulitis:
Pseudoephedrine is not contraindicated for diverticulitis. However, it may cause gastrointestinal side effects such as abdominal discomfort or constipation, which could exacerbate symptoms in individuals with diverticulitis. Therefore, caution should be exercised when using pseudoephedrine in these clients.

C) Hypertension:
This is the correct answer. Pseudoephedrine is a sympathomimetic drug that can cause vasoconstriction and increase blood pressure. Therefore, it is contraindicated in clients with hypertension or cardiovascular disease, as it may exacerbate these conditions and increase the risk of adverse cardiovascular events such as hypertensive crisis or stroke.

D) Eczema:
Pseudoephedrine is not contraindicated for eczema. However, it may cause dryness of the skin and exacerbate existing dermatological conditions. Clients with eczema should use pseudoephedrine cautiously and monitor for any worsening of their skin condition.

A. Severe pain. B. Frequent episodes of painful urination C. An inability to void D. Bladder spasms

Correct Answer is C

Explanation

Bethanechol is not indicated for the relief of severe pain following a transurethral resection of the prostate (TURP). Pain management for postoperative discomfort typically involves analgesics such as opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), depending on the severity of pain. Therefore, this option is incorrect.

B) Frequent episodes of painful urination:
While frequent episodes of painful urination may occur after a TURP due to irritation of the urinary tract, bethanechol is not typically administered to address this symptom. Painful urination is often managed with analgesics and may improve as the urinary tract heals. Therefore, this option is incorrect.

C) An inability to void:
This is the correct response. Bethanechol is a cholinergic agonist that stimulates bladder contraction and can be used to treat urinary retention or an inability to void following surgical procedures such as TURP. By increasing bladder tone and promoting urination, bethanechol helps relieve urinary retention and prevents complications associated with prolonged bladder distension.

D) Bladder spasms:
While bladder spasms may occur postoperatively following a TURP, bethanechol is not typically administered to address this symptom. Bladder spasms are often managed with anticholinergic medications or muscle relaxants to reduce involuntary contractions of the bladder. Therefore, this option is incorrect.”

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A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who reports taking pseudoephedrine for sinus congestion as needed. The nurse should identify that pseudoephedrine is contraindicated for which of the following client conditions?

Correct Answer is C

Explanation

A nurse is caring for a client who is postoperative following a transurethral resection of the prostate (TURP). The nurse should plan to administer the client’s PRN bethanechol when the client reports which of the following manifestations?

Correct Answer is C

Explanation

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