A nurse is assessing a client who has muscarinic agonist poisoning. Following administration of atropine, which of the following findings should indicate to the nurse that the treatment has been effective?

Hyperactive bowel sounds

Heart rate 90/min

Blood pressure 90/50 mm Hg

Increased salivation

Answer and Explanation

The Correct Answer is B

B. Muscarinic agonists can cause bradycardia (slow heart rate) due to increased vagal tone. Atropine, as a muscarinic antagonist, increases heart rate by blocking the vagal effects on the heart. A heart rate of 90/min suggests normalization of heart rate, indicating that atropine has been effective in reversing bradycardia.

A. Muscarinic agonists can cause excessive gastrointestinal motility and increased bowel sounds. Atropine, by blocking muscarinic receptors, reduces gastrointestinal motility and can lead to decreased bowel sounds. Therefore, hyperactive bowel sounds would suggest ongoing muscarinic stimulation and inadequate response to atropine.

C. Muscarinic agonists can cause hypotension (low blood pressure) due to vasodilation and decreased cardiac output. Atropine can cause mild to moderate increases in blood pressure by blocking vasodilation and increasing sympathetic tone. A blood pressure of 90/50 mm Hg suggests persistent hypotension and inadequate response to atropine.

D Muscarinic agonists can cause excessive salivation and secretions. Atropine reduces salivation and secretions by blocking muscarinic receptors. Therefore, increased salivation would indicate ongoing muscarinic stimulation and insufficient response to atropine.

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Correct Answer is A

Explanation

A Epinephrine activates beta-adrenergic receptors, leading to increased heart rate, myocardial contractility, and oxygen consumption. This can cause chest pain, especially in clients with underlying cardiovascular disease or coronary artery disease. Chest pain after epinephrine administration should be promptly reported to assess for possible myocardial ischemia or infarction.

B. Epinephrine primarily acts on beta-adrenergic receptors to increase heart rate and cardiac output. Bradycardia is an unexpected finding after epinephrine administration and may indicate an abnormal response or potential adverse effect, possibly due to excessive alpha-adrenergic receptor stimulation or an underlying condition. It should be promptly reported for further evaluation and management.

C. Epinephrine can stimulate glycogenolysis and gluconeogenesis, leading to transient hyperglycemia. However, in susceptible individuals, particularly those with diabetes or those receiving insulin therapy, epinephrine can cause hypoglycemia due to enhanced glucose uptake and utilization. Symptoms of hypoglycemia, such as confusion, sweating, and tremors, should be monitored and managed promptly if observed.

D. Epinephrine primarily acts as a bronchodilator through beta-2 adrenergic receptor stimulation, leading to improved airway patency and increased respiratory rate. Respiratory depression is an uncommon adverse effect of epinephrine and is typically not expected after its administration. If respiratory depression occurs, it may indicate a severe reaction or overdose, requiring immediate intervention and reporting.

A. Eyelid edema B. Nausea C. Insomnia D. Dry cough

Correct Answer is A

Explanation

A. Eyelid edema (swelling) can be a sign of angioedema, which is a rare but serious side effect of ACE inhibitors like lisinopril. Angioedema involves swelling of deeper layers of the skin, often around the eyes, lips, tongue, throat, and sometimes the hands and feet. It can lead to airway obstruction and is potentially life-threatening. Immediate medical evaluation and possibly discontinuation of the medication are necessary if angioedema is suspected.

B. Nausea is a common side effect of many medications, including lisinopril, but it is generally not considered a serious adverse reaction unless severe or persistent.

C Insomnia (difficulty sleeping) can occur as a side effect of medications but is not typically associated with lisinopril to the extent of warranting immediate reporting.

D. A dry, persistent cough is a well-known side effect of ACE inhibitors like lisinopril.

Rationale: While annoying and uncomfortable, a dry cough is usually not dangerous and can be managed with symptomatic treatment or, if severe, by switching to a different class of antihypertensive medication.

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A nurse is assessing a client who has muscarinic agonist poisoning. Following administration of atropine, which of the following findings should indicate to the nurse that the treatment has been effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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