A male patient was discussing with the nurse that he was experiencing problems urinating after taking an antihistamine that has anticholinergic properties and was wondering why this was happening. Which statement by the nurse explains this effect?

“Antihistamines are used to treat allergy symptoms, and do not affect the bladder.”

“This medication you are taking has the effect of causing dry mouth and sedation, but I never heard of it causing urinary retention.”

“I am sure your symptoms will get better if you wait a few weeks and let your body adjust to the medication.”

“Your medication is causing your bladder to relax because it is inhibiting the cholinergic receptors, therefore the bladder is slower to contract to expel the urine.”

Answer and Explanation

The Correct Answer is D

Anticholinergic effects of certain medications, including some antihistamines, can impact the parasympathetic nervous system. This can lead to reduced smooth muscle activity, especially in organs like the bladder. Nurses must be able to explain these effects clearly to help clients understand and manage their symptoms.

Rationale for correct answer:

4. “Your medication is causing your bladder to relax because it is inhibiting the cholinergic receptors, therefore the bladder is slower to contract to expel the urine.”
This explanation is accurate and appropriate. Anticholinergic activity reduces detrusor muscle contraction, which delays urine expulsion and may lead to urinary retention.

Rationale for incorrect answer:

1. “Antihistamines are used to treat allergy symptoms, and do not affect the bladder.”
This response is inaccurate. Many antihistamines with anticholinergic effects can impair bladder contraction, especially in older adults or males with prostatic hypertrophy.

2. “This medication you are taking has the effect of causing dry mouth and sedation, but I never heard of it causing urinary retention.”
Minimizing or being unaware of a known side effect such as urinary retention reflects a lack of pharmacologic understanding and could delay proper client education or treatment.

3. “I am sure your symptoms will get better if you wait a few weeks and let your body adjust to the medication.”
Telling the client to wait without addressing a potentially serious side effect may risk complications like urinary retention and bladder distention.

Take-home points:

Anticholinergic drugs can cause urinary retention by reducing bladder muscle contractility.
Nurses should assess for and educate clients about common anticholinergic side effects such as dry mouth, constipation, and urinary retention.
Client concerns about side effects should be addressed with clear explanations based on the drug’s mechanism of action.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","E"]

Explanation

Atropine sulfate is an anticholinergic medication commonly used preoperatively to reduce secretions and prevent bradycardia. However, because of its systemic antimuscarinic effects, it should be used cautiously in patients with certain chronic conditions where these effects may worsen the clinical status.

Rationale for correct answer:

1. Hypertension
Atropine can increase heart rate and reduce vagal tone, potentially worsening blood pressure in hypertensive patients by increasing sympathetic activity.

2. Asthma
Although anticholinergics can have bronchodilating effects, atropine may thicken bronchial secretions, posing a risk of airway obstruction in patients with reactive airway disease like asthma.

3. Closed-angle glaucoma
Atropine causes pupil dilation (mydriasis), which can precipitate acute angle closure in patients with closed-angle glaucoma, leading to severe eye pain and vision loss.

5. Enlarged prostate (BPH)
Anticholinergic effects of atropine can worsen urinary retention in patients with benign prostatic hyperplasia by inhibiting bladder contraction and detrusor muscle tone.

Rationale for incorrect answer:

4. Open-angle glaucoma
Although less risky than closed-angle glaucoma, atropine is generally avoided in open-angle glaucoma unless the benefits outweigh potential increases in intraocular pressure.

6. Irritable bowel syndrome
Atropine may actually be therapeutic in IBS due to its ability to reduce gastrointestinal spasms, making it generally appropriate in this context.

Take-home points:

Atropine should be used cautiously in patients with glaucoma, BPH, asthma, or hypertension due to risk of worsening symptoms.
Its anticholinergic properties can increase intraocular pressure and urinary retention.
Preoperative medication review must always consider comorbidities that may be aggravated by prescribed drugs.

A. Peptic ulcer disease B. Bradycardia C. Decreased sexual function D. Irritable bowel syndrome

Correct Answer is ["A","B","D"]

Explanation

Anticholinergic drugs block the action of acetylcholine in the parasympathetic nervous system. They are often used to decrease secretions, relax smooth muscles, and increase heart rate. Understanding their therapeutic use is essential for selecting appropriate treatment conditions.

Rationale for correct answers:

1. Peptic ulcer disease
Anticholinergics reduce gastric acid secretion and slow gastrointestinal motility, which can help alleviate ulcer symptoms and reduce acid-related irritation in the GI tract.

2. Bradycardia
By inhibiting parasympathetic stimulation to the heart, anticholinergics like atropine can increase heart rate, making them useful in treating symptomatic bradycardia.

4. Irritable bowel syndrome (IBS)
Anticholinergics can reduce abdominal cramping and spasms in IBS by relaxing intestinal smooth muscle and decreasing motility.

Rationale for incorrect answer:

3. Decreased sexual function
Anticholinergics are not prescribed to treat decreased libido or sexual dysfunction. In fact, they may worsen this issue due to side effects like decreased lubrication or erectile difficulty.

Take-home points:

Anticholinergics are helpful in conditions involving excessive secretions, smooth muscle spasms, or parasympathetic overactivity.
Common therapeutic uses include bradycardia, IBS, and peptic ulcer disease.
They are not indicated for sexual dysfunction and may even contribute to it as a side effect.

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A male patient was discussing with the nurse that he was experiencing problems urinating after taking an antihistamine that has anticholinergic properties and was wondering why this was happening. Which statement by the nurse explains this effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse reviewing a patient’s preoperative medications noted that atropine sulfate was listed. In which diagnoses should atropine sulfate be used with caution? Select all that apply

Correct Answer is ["A","B","C","E"]

Explanation

Anticholinergics may be ordered for which of the following conditions? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

A male patient was discussing with the nurse that he was experiencing problems urinating after taking an antihistamine that has anticholinergic properties and was wondering why this was happening. Which statement by the nurse explains this effect?

The client or family of a client taking tacrine (Cognex) should be taught to be observant for which of the following adverse effects that may signal that a possible overdose has occurred?

The nurse will monitor the patient taking albuterol (Proventil) for which conditions? Select all that apply.

The client taking benztropine (Cogentin) should be provided education on methods to manage which common adverse effect?

The patient in the scenario who has recently been prescribed a beta-adrenergic blocking agent now presents to the emergency department with shortness of breath. Which adverse effect from the medications is the patient likely exhibiting?

Propranolol (Inderal) has been ordered for a client with hypertension. Because of adverse effects related to this drug, the nurse would carefully monitor for which adverse effect?

A client is receiving bethanechol (Urecholine). The nurse realizes that the action of this drug is to treat which condition?