Post-anesthetic medications such as opioids, proethazine, ondansetron, promethazine, droperidol, bethanechol. Why would bethanechol be used post surgery?
Bethanechol is a powerful pain reliever
Bethanechol is a powerful antiemetic
Bethanechol is used for abdominal distention and urinary retention
Bethanechol is used for mild pain
The Correct Answer is C
A. Bethanechol is not an analgesic and has no effect on pain pathways. Postoperative pain is typically managed with opioids, acetaminophen, NSAIDs, or regional anesthesia, depending on the type and severity of the pain. Using bethanechol for pain relief would be ineffective and inappropriate.
B. Postoperative nausea and vomiting are common and usually treated with medications such as ondansetron, promethazine, or droperidol. Bethanechol does not have antiemetic properties and would not be effective for preventing or treating nausea or vomiting.
C. Bethanechol is a cholinergic agonist that stimulates muscarinic receptors in the bladder and gastrointestinal tract, promoting smooth muscle contraction. After surgery, anesthesia and opioid medications can decrease parasympathetic activity, leading to urinary retention and abdominal distention from decreased gut motility. By stimulating smooth muscle contraction, bethanechol helps patients urinate and pass gas or stool, restoring normal bladder and bowel function. This use is particularly important because urinary retention can lead to bladder overdistention, discomfort, and infection, while delayed gastrointestinal motility can contribute to ileus and prolonged hospital stays.
D. Bethanechol has no analgesic properties. Its role in postoperative care is functional, targeting urinary and gastrointestinal complications rather than providing pain relief.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Propranolol does not significantly increase insulin requirements through receptor blocking. While beta-blockers affect adrenergic receptors, they do not directly cause a predictable increase in insulin dosage needs.
B. Beta-blockers are not primarily associated with causing insulin resistance. Their main concern in diabetic patients is related to hypoglycemia awareness rather than altering insulin sensitivity.
C. The combination of insulin and propranolol does not directly increase the risk of diabetic ketoacidosis. Ketoacidosis is typically related to insufficient insulin, infection, or stress, not beta-blocker use.
D. Propranolol is a nonselective beta-blockerthat can mask the adrenergic warning signs of hypoglycemia, such as tachycardia, tremors, and anxiety. This makes it more difficult for the patient to recognize low blood glucose levels early. Although sweating may still occur, the absence of typical warning signs increases the risk of severe hypoglycemia.
Correct Answer is A
Explanation
A. Sulfonylureasare oral hypoglycemic agents that stimulate pancreatic beta cells to release insulin. They are used exclusively in type 2 diabetes, as type 1 diabetes patients lack functional beta cells. A notable adverse effect of some first-generation sulfonylureas (e.g., chlorpropamide) is a disulfiram-like reactionwhen alcohol is consumed, causing flushing, nausea, vomiting, and hypotension. Examples include glipizide, glyburide, and glimepiride(second-generation sulfonylureas), which are safer but still can cause hypoglycemia.
B. Biguanides(e.g., metformin) do not stimulate insulin release; instead, they reduce hepatic glucose production and improve insulin sensitivity. They are used in type 2 diabetes but do not cause a disulfiram-like reaction.
C. Meglitinides(e.g., repaglinide, nateglinide) also stimulate insulin release, but they have a shorter duration of actionand do not typically cause a disulfiram-like reaction.
D. Thiazolidinediones(e.g., pioglitazone, rosiglitazone) increase insulin sensitivityin peripheral tissues rather than stimulating insulin release. They are used only for type 2 diabetes and do not cause a disulfiram-like reaction.
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