Answer to Question 1
ANS: D
Benadryl is an antihistamine, and even though it is not classified as a muscarinic antagonist, it has anticholinergic effects. Giving it with a muscarinic antagonist greatly enhances these effects, so it should not be used. Muscarinic antagonists cause dry mouth, and patients should be taught to use sugar-free gum or candies to help with this. Muscarinic antagonists can cause constipation, and laxatives may be used. Medication applied topically can be transferred to others who come in contact with the skin, so the site should be covered.
Answer to Question 2
ANS: C
The transdermal patch is applied weekly and may be the best option for a patient who is more likely to forget to take a daily medication. The transdermal preparation has fewer side effects than the systemic dose so is less likely to increase this patient's constipation. Behavioral therapy should be tried first in patients who can participate. However, it is not the best option for a forgetful patient who lives alone, because it requires scheduled voiding and timing of fluid intake. The extended-release tablets must be given daily, and this patient may not remember to take them. PTNS is used after behavioral and drug therapies have failed.
The nurse assists the patient in reflecting on his feelings
Patient with osteoarthritis
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