Prior to administering a prescribed muscarinic agonist, the nurse ...

[Mr.Thesaxman]

Prior to administering a prescribed muscarinic agonist, the nurse reviews the client's medical history and decides to withhold the medication until contacting the health care provider.
 
  Which findings in the medical history support withholding the medication?
  Standard Text: Select all that apply.
  1. The client's bowel sounds are absent.
  2. The client is currently being treated for asthma.
  3. The client has ventricular dysrhythmia.
  4. The client has a diagnosis of arthritis.
  5. The client has spinal stenosis.

Question 2

What is the most significant difference between neostigmine and pyridostigmine?
 
  1. Neostigmine has no adverse effects.
  2. Neostigmine has a longer duration of action.
  3. Neostigmine has a shorter duration of action.
  4. Neostigmine cannot counteract neuromuscular blocking effect.

[vickyvicksss]

Answer to Question 1

Correct Answer: 1,2,3
Rationale 1: Muscarinic agonists should not be provided when an obstruction of the gastrointestinal tract is suspected because the medication increases peristalsis and could cause a bowel rupture.
Rationale 2: Muscarinic agonists should not be given to those with respiratory disease because the medication causes bronchoconstriction .
Rationale 3: Muscarinic agonists should not be given to those with serious cardiac disease because of the risk for reflex tachycardia.
Rationale 4: Muscarinic agonists are not contraindicated in those with arthritis.
Rationale 5: Muscarinic agonists are not contraindicated in those with spinal stenosis.
Global Rationale: Muscarinic agonists should not be provided when an obstruction of the gastrointestinal tract is suspected because the medication increases peristalsis and could cause a bowel rupture. Muscarinic agonists should not be given to those with respiratory disease because the medication causes bronchoconstriction . Muscarinic agonists should not be given to those with serious cardiac disease because of the risk for reflex tachycardia. Muscarinic agonists are not contraindicated in those with arthritis or spinal stenosis.

Answer to Question 2

Correct Answer: 3
Rationale 1: Neostigmine causes a higher frequency of adverse effects.
Rationale 2: Neostigmine has a shorter duration of action than pyridostigmine.
Rationale 3: Neostigmine has a shorter duration of action than pyridostigmine.
Rationale 4: Neostigmine is indicated for the reversal of the effects of neuromuscular blocking agents after surgery.
Global Rationale: Neostigmine has a shorter duration of action than pyridostigmine. Neostigmine causes a higher frequency of adverse effects. Neostigmine has a shorter duration of action than pyridostigmine. Neostigmine is indicated for the reversal of the effects of neuromuscular blocking agents after surgery.

[Mr.Thesaxman]

Excellent

[LVPMS]

TYSM