Chapter 16

Question 1

Drugs that stimulate the PNS to cause a response

Answer 1

Cholinergic

Question 2

Drugs that block receptors to block a response

Answer 2

Anticholinergic

Question 3

Affects smooth muscle (heart)

Answer 3

Muscarinic

Question 4

Affects skeletal muscle.

Answer 4

Affects skeletal muscle

Question 5

How do drugs stimulate the PNS?

Answer 5

Mimic parasympathetic neurotransmitter acetylcholine

Question 6

What are the two types of cholinergic receptors?

Answer 6

Muscarinic receptors
- Affect smooth muscles
Nicotinic receptors
- Affect skeletal muscles

Question 7

What happens to the cardiovascular system when a cholinergic agonsit is given?

Answer 7

Decreased pulse, BP, vasodilation, slows conduction of AV node

Question 8

What happens to the GI system when a cholinergic agonsit is given?

Answer 8

Increased tone and motility, increased peristalsis, relax sphincter muscles

Question 9

What happens to the GU system when a cholinergic agonsit is given?

Answer 9

Increased ureter tone, contract bladder and relax sphincter muscles, stimulate urination

Question 10

What happens to the eyes when a cholinergic agonsit is given?

Answer 10

Constrict pupils, increase accommodation

Question 11

What happens to the lungs when a cholinergic agonsit is given?

Answer 11

Bronchial constriction, increase secretions

Question 12

What happens to the glands when a cholinergic agonsit is given?

Answer 12

Increase salivation, perspiration, and tears

Question 13

What happens to the striated muscles when a cholinergic agonsit is given?

Answer 13

Increase neuromuscular transmission, maintain muscle strength and tone

Question 14

What are 3 common cholinergic agonists and why are they given?

Answer 14

metoclopramide (reglan)
- Increase gastric emptying
Pilocarpine (pilocar)
- Constrict pupils
Bethanechol chloride (urecholine)
- Increase urination

Question 15

What should the nurse monitor when giving a cholinergic agonist?

Answer 15

Nursing interventions
◦ Monitor BP and HR
◦ Teach client to rise slowly (orthostatic hypotension)
◦ Record fluid intake and output.
◦ Monitor breath sounds (increased secretions)
◦ Monitor bowel sounds.
◦ Keep linens clean and dry (increased perspiration)
◦ Monitor for overdose:
◦ salivation, sweating, flushing, abdominal cramps
◦ Antidote: Atropine

Question 16

What is the action of anticholinergics?

Answer 16

Inhibit action of ACh by occupying ACh receptors

Question 17

What effect do anticholinergics have on the heart?

Answer 17

Large doses increase HR; small doses decrease HR

Question 18

What effect do anticholinergics have on the lungs?

Answer 18

Bronchodilation, decrease secretions

Question 19

What effect do anticholinergics have on the GI system?

Answer 19

Relax smooth muscle tone, decrease motility and peristalsis, decrease secretions.

Question 20

What effect do anticholinergics have on the GU system?

Answer 20

Relax detrusor muscle, increase sphincter constriction.

Question 21

What effect do anticholinergics have on the eyes?

Answer 21

Dilate pupils, decrease accomodation

Question 22

What effect do anticholinergics have on the glands?

Answer 22

Decrease salivation and perspiration.

Question 23

What effect do anticholinergics have on the CNS?

Answer 23

Decrease tremors and rigidity

Question 24

What assessment should be done when a patient receives anticholinergic?

Answer 24

Assess for dry mouth, urinary retention, constipation, blurred vision

Question 25

What would happen to the pupil when a person receives anticholinergic drops?

Answer 25

Myrdiasis Dilation of pupil

Question 26

What does atropine do?

Answer 26

- Increase HR - Decrease motility and peristalsis - Decrease salivary secretions - Antidote for muscarinic poisoning

Question 27

What are the contraindications for atropine?

Answer 27

Glaucoma Any kind of obstruction Tachycardia

Question 28

What should the nurse monitor/teach to a patient prescribed atropine?

Answer 28

Nursing interventions and Patient Teaching ◦ Monitor vital signs, urine output, bowel sounds. ◦ Monitor safety: bedside rails, driving motor vehicles ◦ Provide mouth care and eye drops. ◦ Ice chips and hard candy for dry mouth. ◦ Avoid hot environments. ◦ Wear sunglasses in bright light. ◦ Increase fluid intake ◦ Increase fiber intake

Question 29

Why are antihistamines used?

Answer 29

To treat motion sickness Example scopolamine

Question 30

What is the route of scopolamine?

Answer 30

Transdermal patch- applied 4 hours prior to activity and change every 3 days. Placed behind ear

Question 31

What are the side effects of scopolamine?

Answer 31

- Dry mouth - Constipation - Urinary retention - Tachycardia - Hypotension - Visual disturbances

Question 32

A nurse is caring for a client who has had atropine. Which problem would the nurse rate as the highest priority for this client? A. Anxiety B. Constipation C. Urinary retention D. Impaired oral mucous membrane

Answer 32

D. Impaired oral mucous membrane

Question 33

Which action should the nurse consider appropriate for the client who is taking atropine? A. Give the drug with meals. B. Monitor the client’s vital signs. C. Auscultate breath sounds for rales. D. Observe for orthostatic hypotension.

Answer 33

B. Monitor the client’s vital signs.