A patient receives topical atropine to facilitate an eye ...

[rmenurse]

A patient receives topical atropine to facilitate an eye examination. The nurse will tell the patient to remain in a darkened room or to wear sunglasses for several hours until the effects of the medication wear off.
 
  This teaching is based on the nurse's knowledge that muscarinic antagonists cause:
  a. elevation of intraocular pressure.
  b. miosis and ciliary muscle contraction
  c. paralysis of the iris sphincter.
  d. relaxation of ciliary muscles.

Question 2

A prescriber has ordered pilocarpine (Pilocar). A nurse understands that the drug stimulates muscarinic receptors and would expect the drug to have which action?
 
  a. Reduce excessive secretions in a postoperative patient
  b. Lower intraocular pressure in patients with glaucoma
  c. Inhibit muscular activity in the bladder
  d. Prevent hypertensive crisis

[xiazhe]

Answer to Question 1

ANS: C
By blocking muscarinic receptors in the eye, atropine causes paralysis of the iris sphincter, which prevents constriction of the pupil; consequently, the eye cannot adapt to bright light. This also causes an elevation in intraocular pressure, which increases the risk of glaucoma. However, it is not an indication for wearing darkened glasses. Muscarinic agonists cause miosis; atropine causes mydriasis. The effect of relaxing ciliary muscles focuses the eye for far vision, causing blurred vision.

Answer to Question 2

ANS: B
Pilocarpine is a muscarinic agonist used mainly for topical therapy of glaucoma to reduce intraocular pressure. Pilocarpine is not indicated for the treatment of excessive secretions and mucus; in fact, pilocarpine is used to treat dry mouth. Pilocarpine does not inhibit muscular activity in the bladder. Pilocarpine is not used to prevent hypertensive crisis.

[rmenurse]

Thank you!

[xiazhe]

Always glad to help...