Author Question: A patient who has esophageal cancer is experiencing dry mouth and the provider orders oral ... (Read 126 times)

Evvie72 · **on:** Jul 23, 2018

A patient who has esophageal cancer is experiencing dry mouth and the provider orders oral pilocarpine to treat this symptom. What will the nurse expect to teach this patient about this me-dication?

a. This medication may cause rapid heart rate and elevated blood pressure.
b. This medication may cause constipation and gastric discomfort in large doses.
c. You should experience sweating with this medication and should not have other side effects.
d. You will begin taking 5 mg three times daily and may increase the dose to 10 mg.

Question 2

An alcoholic patient's spouse asks a nurse about recovery from chronic alcoholism. The patient is confused and has abnormal eye movements and nystagmus. Which statement by the nurse is correct?

a. The symptoms your spouse shows are partly reversible in most people.
b. These symptoms can be reversed with vitamin therapy and good nutrition.
c. Your spouse has symptoms of an irre-versible encephalopathy.
d. Your spouse will probably recover com-pletely after detoxification.

bbburns21 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

D
The dosing for pilocarpine, when used for dry mouth associated with head and neck cancers, is 5 mg three times daily, which may be titrated up to 10 mg three times daily. Tachycardia and con-stipation are side effects of atropine. Sweating occurs with low doses of pilocarpine. Higher dos-es, such as this, are associated with the full range of muscarinic effects.

Answer to Question 2

B
Chronic use of alcohol can produce severe neurologic and psychiatric disorders. This patient shows signs of Wernicke's encephalopathy, which is readily reversible with thiamine. With proper nutrition, the symptoms will clear completely. Korsakoff's psychosis is not reversible; signs of this disorder include polyneuropathy, memory disorders, and confabulation. Wernicke's encephalopathy requires thiamine supplementation and not just detoxification, which is treatment to withdraw alcohol from the patient's system.