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?

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.

A) Beta 1: Beta-1 adrenergic receptors are primarily located in the heart and are responsible for increasing heart rate (chronotropy), the force of contraction (inotropy), and the conduction speed of electrical impulses within the heart (dromotropy). When a drug is given to increase heart rate and myocardial activity, it is stimulating the beta-1 receptors, which enhance the heart's performance..

B) Beta 2: Beta-2 receptors are predominantly found in smooth muscles, such as those
in the bronchi, blood vessels, and uterus. Stimulation of beta-2 receptors leads to relaxation of these muscles, including bronchodilation and vasodilation, which would not have a direct effect on increasing heart rate or myocardial activity.

C) Alpha 2: Alpha-2 receptors are primarily located in the central nervous system (CNS) and act to inhibit the release of norepinephrine, leading to a reduction in sympathetic nervous system activity. They have the opposite effect of what is desired in this case, as stimulation of alpha-2 receptors would actually lower heart rate and decrease myocardial activity, not increase it.

D) Alpha 1: Alpha-1 receptors are found in the smooth muscle of blood vessels and when stimulated, cause vasoconstriction, which increases blood pressure. While alpha-1 receptors do affect the cardiovascular system, they do not directly influence heart rate or myocardial contractility.