What are anticholinergic adverse effects and what are

nursing interventions/client education points related to

these?
1. Dry mouth, blurred vision, photophobia, urinary
hesitancy or retention, constipation, tachycardia
2. Interventions/education: chewing sugarless gum,

sipping of water,avoiding hazardous activities,

wearing sunglasses when outdoors,eating foods high
in fiber,participating in regular exercise,maintaining
fluid intake of 2 to 3 L/day from beverages and food
sources, andvoiding just before taking medication.

A nurse is preparing to administer gentamicin to a client.

What are three (3) contraindications/precautions for this
medication?
1. High risk for ototoxicity and nephrotoxicity
2. Monitor creatinine and BUN
3. Peak and trough levels
A nurse is administering vancomycin to a client who
develops an infusion reaction (red man syndrome). What
action by the nurse could have prevented this reaction?
1. Rapid infusion
A nurse is preparing to administer lorazepam (Ativan) to a
client. List three (3) indications for the use of this
medication.
1. Anxiety disorder
2. Short-term symptoms of anxiety
3. Anxiety associated with depressive symptoms
A client has been prescribed intranasal calcitonin
(Miacalcin) for the treatment of osteoporosis. What client
education should be provided by the nurse to prevent
nasal dryness and irritation?
1. Avoid any other nasal sprays and nasal medicines at the
same time
An oncology client has been prescribed cyclophosphamide
(Cytoxan). What is the pharmacological action and
therapeutic uses of this medication?
1. Treat cancer including leukemia and lymphomas

2. Alkylating agent with an effective anticancer activity

A client with diabetes mellitus whose blood glucose levels
are well controlled with current oral therapy asks the nurse
when he may require insulin. What information should the
nurse provide?
1. The need for immediate release vs. oral route
A client with adrenocortical insufficiency (Addison's
disease) has been prescribed fludrocortisone (Florinef).
What is an adverse effect of this medication and nursing
interventions to monitor for this effect?
1. Infection (check for indications of infection, labs)
2. Hyperglycemia (check blood glucose level)
3. Fluid retention (objective findings of fluid retention)
A client has been prescribed timolol (Timoptic). What are
three (3) possible adverse effects of this medication and
nursing interventions/client education related to these
effects?
1.
A nurse is placing an IV line on an older adult client. List
three (3) considerations the nurse should take when
placing an IV line in this client?
1. 22 or 24 gauge
2. Use tourniquet sparingly
3. Lower angle of insertion
A client receiving methyldopa (Aldomet) for blood pressure
control. List three (3) adverse effects of this medication.
1. Dry mouth
2. Rebound hypertension
3. Black or sore tongue
A critical care client with hypertensive crisis is given
nitroprusside (Nipride). Provide the expected
pharmacological action of this medication therapy?
1. Direct vasodilation of arteries and veins resulting in
rapid reduction of blood pressure (decreased preload
and afterload)
A client has been prescribed tadalafil (Cialis) for the
treatment of erectile dysfunction. What medications

and/or food interactions should the nurse include in client

education about this medication?
1. Grapefruit
2. Alcohol
3. Erythromycin, keroconazole, nitrates, rifampin, and
doxazosin
A client has been prescribed oxybutynin (Ditropan) for
treatment of overactive bladder and has been
experiencing anticholinergic side effects. List two (2)
actions the client will take to prevent adverse effects of the
medication therapy.
1. Sucking on hard candy or chewing gum
2. Administering stool softeners to prevent constipation
A client asks the nurse why she is prescribed bethanechol
(Urecholine). What therapeutic effect and indication for the
client can the nurse identify this medication therapy?
1. Indicated for urinary retention and saliva production
stimulator
2. Parasympathomimetic choline that selectively
stimulates muscarinic receptors without any effect on
nicotinic receptors
A client has been prescribed sumatriptan (Imitrex) for the
treatment of migraines. What are three (3)
contraindications to this medication?
1. Hypersensitivity
2. Heart or liver disease
3. PVD
4. Current use of MAOIs
A client during a minor surgical procedure received an
injection of local anesthetic. What teaching points should
be provided to this client following this procedure?
1. Could last up to several hours
2. It affects the pain sensation where injected and close by
3. Does not affect memory
A nurse is preparing to administer amphotericin B to a
client. What are three (3) potential adverse effects of this
medication and the associated nursing interventions to
prevent and address these reactions?
1. Hypersensitivity (monitor vital signs and temperature)

2. Nephrotoxicity (monitor labs such as CBC, BUN, and

creatinine)
3. Electrolyte imbalance hypokalemia, hyperglycemia,
hypocalcemia, hypomagnesemia (monitor labs)
A client has been prescribed the disease-modifying
antirheumatic drug hydroxychloroqine for the treatment of
rheumatoid arthritis. Identify one (1) points the nurse
should reinforce teaching on regarding this medication.
1. Monitor ways and measures to prevent infection
A client has been prescribed cyanocobalamin (Nascobal).
What information should be provided to the client
regarding self-administration of this medication?
1. You can inject it into the muscle, called an intramuscular shot, or under
the skin, called a subcutaneous shot.