The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

Irritable bowel disease

Glaucoma

Asthma

Hypertension

Answer and Explanation

The Correct Answer is B

A) Irritable bowel disease: Benztropine is an anticholinergic medication that can reduce gastrointestinal motility, which might exacerbate constipation. However, irritable bowel disease (IBD) is not a contraindication for using benztropine. The drug is more likely to cause concern in conditions where smooth muscle relaxation could worsen symptoms of constipation, but it is not typically withheld due to IBD alone.

B) Glaucoma: Glaucoma, particularly narrow-angle glaucoma, is a contraindication for benztropine use. Benztropine, as an anticholinergic agent, can cause pupil dilation (mydriasis), which can increase intraocular pressure and worsen glaucoma. This is a critical concern for patients with glaucoma, and the healthcare provider should be notified before administering the drug.

C) Asthma: While benztropine can have mild anticholinergic effects that may cause dryness of the respiratory tract, it is not a contraindication for asthma. Beta-agonist inhalers are more commonly prescribed to manage bronchospasm, but the use of benztropine in asthma is not typically harmful unless the patient is experiencing severe respiratory distress. Asthma would not be a primary concern when administering this medication.

D) Hypertension: Benztropine does not directly affect blood pressure in a way that would be a concern for someone with hypertension. While it may cause some mild autonomic changes (like dry mouth or dizziness), hypertension is not a contraindication for the medication. Therefore, there is no specific need to notify the healthcare provider due to a history of hypertension.

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Correct Answer is C

Explanation

A) Risk for dehydration related to diarrhea:
Diarrhea is not a common issue directly associated with Parkinson’s disease or its typical treatments, such as dopaminergic medications. While some medications or conditions can cause gastrointestinal disturbances, dehydration due to diarrhea is not a primary concern in Parkinson’s disease.

B) Diarrhea related to dopaminergic effects:
Dopaminergic medications, such as levodopa, may cause gastrointestinal side effects, but diarrhea is not a primary or common side effect. Typically, dopaminergic effects can lead to constipation, not diarrhea.

C) Risk for injury related to CVS effects and incidence of orthostatic hypotension:
Parkinson's disease can cause autonomic dysfunction, which often leads to orthostatic hypotension increasing the risk of falls and injury. This is a valid and appropriate nursing diagnosis because patients with Parkinson’s disease often experience balance issues and dizziness due to this condition, making them more vulnerable to falls and injury.

D) Constipation related to dopaminergic effects:
While constipation is a common side effect of dopaminergic medications used to treat Parkinson's disease, the more appropriate diagnosis for a patient who has Parkinson’s disease would be one that addresses the immediate risks or complications related to mobility or autonomic dysfunction.

A. The cell body of the first motor neuron that lies in the brain stem B. Reflex circuitry produce by the ANS reflex C. Parasympathetic effect on the vagus nerve D. Secretion of the sympathetic neurotransmitters produce in the adrenal medulla

Correct Answer is D

Explanation

A) The cell body of the first motor neuron that lies in the brain stem:
This option refers to the somatic nervous system, which controls voluntary muscle movements. In response to a stressful or fearful situation, like the one described, the sympathetic nervous system is activated, not the somatic motor pathways. This is more related to voluntary motor control rather than the autonomic response to stress.

B) Reflex circuitry produced by the ANS reflex:
The autonomic nervous system (ANS) is involved in regulating involuntary functions like heart rate, blood pressure, and digestion. However, the "racing heart" response described here is primarily triggered by the sympathetic division of the ANS due to a stressor, such as seeing the cat. The reflex itself is part of a larger autonomic reaction, but the direct cause of the increased heart rate is the secretion of neurotransmitters.

C) Parasympathetic effect on the vagus nerve:
The parasympathetic nervous system (PNS) generally works to counteract the "fight or flight" response, promoting a relaxed state and slowing the heart rate. The vagus nerve is the primary parasympathetic pathway involved in decreasing heart rate. However, during stress or a fear response, the parasympathetic system is overridden by the sympathetic system, which increases heart rate, making this option incorrect.

D) Secretion of the sympathetic neurotransmitters produced in the adrenal medulla:
When a person experiences a stressor, like the sudden appearance of a cat, the sympathetic nervous system is activated, triggering the release of neurotransmitters like norepinephrine from sympathetic nerve endings and epinephrine (adrenaline) from the adrenal medulla. These chemicals act on the heart, causing it to race in response to the perceived threat.

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The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with Parkinson’s disease. While writing the care plan for this patient what would be an appropriate nursing diagnosis?

Correct Answer is C

Explanation

46) While walking down the street, a cat jumps out of an alley into the pathway of an adult. They note that his /her heart is "racing." this response is primarily due to:

Correct Answer is D

Explanation

In contrast to the sympathetic nervous system, the functions of the parasympathetic nervous system include:

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A patient who has Parkinson disease is being treated with the anticholinergic medication benztropine (Cogentin). The nurse will tell the patient that this drug will have which effect?