A nurse is caring for a child who has otitis media with effusion. The nurse should identify that which of the following manifestations indicates a tympanic membrane rupture?

Choice A reason: Atropine is an anticholinergic medication that blocks the effects of the parasympathetic nervous system. One of its effects is relaxation of the smooth muscles in the bladder, which can lead to urinary retention. This occurs because the bladder's ability to contract is inhibited, making it difficult for the patient to void.

Choice B reason: Bradycardia is not an expected effect of atropine. In fact, atropine is often used to treat bradycardia by increasing heart rate. It works by blocking the vagus nerve's influence on the heart, which normally acts to slow the heart rate. Therefore, atropine would be expected to cause an increase in heart rate, not a decrease.

Choice C reason: Diarrhea is not a common effect of atropine. Atropine works by reducing the activity of the gastrointestinal tract, leading to a decrease in bowel movements and potentially causing constipation rather than diarrhea. Anticholinergic drugs like atropine reduce gastrointestinal motility, which can lead to a slower passage of food through the intestines.

Choice D reason: Vomiting is not typically associated with the administration of atropine. While nausea and vomiting can be side effects of many medications, atropine more commonly causes dry mouth, blurred vision, and constipation. The medication's action on the gastrointestinal tract tends to slow digestive processes rather than stimulate vomiting.

Choice A reason: Defibrillation is the appropriate intervention for pulseless ventricular tachycardia (VT). It delivers an electrical shock to the heart to restore a normal rhythm. Immediate defibrillation is crucial for survival as it can terminate the arrhythmia and allow the heart to re-establish an effective rhythm.

Choice B reason: Vagal maneuvers, such as the Valsalva maneuver, are used to terminate supraventricular tachycardias but are ineffective for pulseless VT. These maneuvers stimulate the vagus nerve to slow the heart rate but do not provide the necessary intervention for life-threatening arrhythmias like pulseless VT.

Choice C reason: Radiofrequency catheter ablation is a procedure used to treat recurrent arrhythmias by destroying abnormal electrical pathways in the heart. It is not an emergency intervention for pulseless VT. Defibrillation is needed to address the immediate, life-threatening situation.

Choice D reason: Administration of atropine is not indicated for pulseless VT. Atropine is used to treat bradycardia by increasing heart rate, but it does not address the underlying cause of VT. Defibrillation is the correct immediate intervention for pulseless VT.