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

Peptic ulcer disease

Bradycardia

Decreased sexual function

Irritable bowel syndrome

Answer and Explanation

Correct Answer : A,B,D

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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Correct Answer is C

Explanation

Bethanechol (Urecholine) is a direct-acting cholinergic agonist prescribed to stimulate bladder emptying in clients with urinary retention. Older adults are more vulnerable to its parasympathomimetic effects, which can lead to cardiovascular and neurological side effects that require close monitoring.

Rationale for correct answer:

3. Dizziness
Dizziness is a common concern in older adults taking bethanechol due to the risk of orthostatic hypotension and decreased cardiac output. This increases the risk for falls, making frequent assessment essential in this population.

Rationale for incorrect answer:

1. Tachycardia
Bethanechol typically causes bradycardia by stimulating the parasympathetic nervous system. Tachycardia is not a common effect of this drug and would not be the primary concern.

2. Hypertension
Cholinergic agonists tend to lower blood pressure through vasodilation and enhanced parasympathetic tone. Hypertension is not a typical adverse reaction.

4. Urinary retention
Bethanechol is used to treat urinary retention by stimulating the bladder. Retention would indicate a lack of therapeutic effect rather than an adverse one.

Take-home points:

Bethanechol stimulates the parasympathetic system and can cause dizziness from hypotension, especially in older adults.
Older clients require close monitoring for orthostatic changes and fall risks while on cholinergic medications.
This drug is intended to treat urinary retention, not cause it, so effectiveness is measured by successful voiding.

A. Insomnia, nervousness, and hypertension B. Nausea, vomiting, and hypotension C. Dry mouth, drowsiness, and dyspnea D. Increased bronchial secretions, hypotension, and bradycardia

Correct Answer is A

Explanation

Phenylephrine (Neo-Synephrine) is a selective alpha-1 adrenergic agonist used for nasal congestion, hypotension, and sometimes to prolong local anesthetic action. Due to its mechanism of vasoconstriction via stimulation of alpha-1 receptors, it can lead to systemic cardiovascular and central nervous system effects that nurses must monitor closely after administration.

Rationale for correct answer:

1. Insomnia, nervousness, and hypertension
These are common adverse effects of phenylephrine due to CNS stimulation and peripheral vasoconstriction. The alpha-1 receptor activation increases blood pressure, and stimulation of the sympathetic nervous system can lead to restlessness and sleep disturbances.

Rationale for incorrect answer:

2. Nausea, vomiting, and hypotension
While nausea and vomiting can occasionally occur, hypotension is not expected with phenylephrine since it is primarily used to increase blood pressure in hypotensive states through vasoconstriction.

3. Dry mouth, drowsiness, and dyspnea
These symptoms are more consistent with anticholinergic agents or CNS depressants, not alpha-1 agonists. Phenylephrine does not typically cause drowsiness or impair airway function.

4. Increased bronchial secretions, hypotension, and bradycardia
Phenylephrine does not increase secretions or cause hypotension. While reflex bradycardia may occur from elevated BP, this triad does not represent typical adverse effects of the drug.

Take-home points:

Phenylephrine, an alpha-1 agonist, causes vasoconstriction, which can lead to hypertension and reflex bradycardia.
Nurses should monitor for CNS stimulation symptoms like insomnia and nervousness after administration.
Adverse effects align with sympathomimetic activity, not parasympathetic or cholinergic effects.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Older adult clients taking bethanechol (Urecholine) need to be assessed more frequently because of which of the following adverse effects?

Correct Answer is C

Explanation

Following administration of phenylephrine (Neo-Synephrine), the nurse would assess for which of the following adverse drug effects?

Correct Answer is A

Explanation

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

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

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

When a patient has a cholinergic overdose from excessive dosing of bethanechol (Urecholine), the nurse anticipates administration of which drug as the antidote?

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 nurse is administering atenolol (Tenormin) to a patient. Which concurrent drugs does the nurse expect to most likely cause an interaction? Select all that apply.