Analyze the following clinical manifestations and determine whether they are characteristic of Anticholinergic or Cholinergic Toxicity.
Hypertension
Urinary Retention
Diaphoresis
Bronchoconstriction
Salivation
Hyperthermia
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"A"}}
- Hypertension: Seen in anticholinergic toxicity due to decreased parasympathetic tone and possible unopposed sympathetic stimulation. The body's inability to relax vascular tone may contribute to elevated blood pressure.
- Urinary Retention: A classic feature of anticholinergic toxicity. Inhibition of muscarinic receptors leads to impaired detrusor muscle contraction, making urination difficult or impossible.
- Hyperthermia: Results from inhibited sweating (anhidrosis), which is a hallmark of anticholinergic toxicity. Without the ability to cool through evaporation, body temperature rises dangerously.
- Diaphoresis: Excessive sweating is mediated by muscarinic receptor activation in cholinergic toxicity. It's often part of the SLUDGE symptoms seen in organophosphate poisoning or cholinesterase inhibitor overdose.
- Bronchoconstriction: Caused by overstimulation of muscarinic receptors in the airways, leading to narrowed bronchi and increased respiratory secretions — a dangerous feature of cholinergic excess.
- Salivation: Prominent in cholinergic toxicity due to unopposed parasympathetic activation. It may occur along with lacrimation, bradycardia, and other signs of excessive cholinergic stimulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Take the medication with milk: Milk contains calcium, which inhibits the absorption of iron by binding with it in the gastrointestinal tract. Taking ferrous sulfate with milk significantly reduces its effectiveness in treating iron-deficiency anemia.
B. Take the medication with orange juice to enhance absorption: Vitamin C (ascorbic acid) in orange juice enhances the absorption of non-heme iron like ferrous sulfate by maintaining it in a more soluble and absorbable form. This maximizes the therapeutic benefit.
C. Take the medication on an empty stomach to decrease gastrointestinal irritation: Iron is best absorbed on an empty stomach, but it often causes GI upset, including nausea and constipation. Patients are typically advised to take it with a small amount of food if intolerance occurs not specifically to reduce GI irritation from the start.
D. Rinse the mouth before taking the iron: Rinsing the mouth beforehand has no clinical benefit. However, patients should be advised to rinse their mouth after taking liquid iron to prevent staining of the teeth, a known side effect of the liquid formulation.
Correct Answer is C
Explanation
A. "I'll dial 911 if I still have pain after taking 3 nitroglycerin tablets 5 minutes apart.": While this reflects part of the correct sequence, waiting until all 3 doses are taken before seeking emergency help may delay life-saving treatment. Emergency services should be contacted sooner if the first dose is ineffective.
B. "I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period.": This exceeds the recommended maximum of three sublingual nitroglycerin tablets within 15 minutes. Taking more than advised can increase the risk of hypotension and other complications.
C. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting.": This is the correct protocol. If chest pain persists after the first dose, the patient should immediately call 911 and may continue with up to two additional doses, each 5 minutes apart, while waiting for emergency responders.
D. "I'll dial 911 when I have pain and then take the nitroglycerin tablets.": Calling 911 immediately without trying the medication first may lead to unnecessary emergency activation. The recommended approach is to take the first dose, then call if pain persists after 5 minutes.
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