A prescriber has ordered bethanechol Urecholine for a ...

[vicotolentino]

A prescriber has ordered bethanechol Urecholine for a postoperative patient who has urinary retention. The nurse reviews the patient's chart before giving the drug.
 
  Which part of the pa-tient's history would be a contraindication to using this drug? a. Asthma as a child
  b. Gastroesophageal reflux
  c. Hypertension
  d. Hypothyroidism

Question 2

A 65-year-old female patient tells a nurse that she has begun taking calcium supplements. The nurse learns that the patient consumes two servings of dairy products and takes 1200 mg in cal-cium supplements each day.
 
  The patient's serum calcium level is 11.1 mg/dL. What will the nurse tell this patient? a. She should increase her dietary calcium in addition to the supplements
  b. The amount of calcium she takes increases her risk for heart attack and stroke
  c. To continue taking 1200 mg of calcium supplement since she is over age 50
  d. To supplement her calcium with 10,000 units of vitamin D each day

[strudel15]

Answer to Question 1

A
Bethanechol is contraindicated in patients with active or latent asthma, because activation of muscarinic receptors in the lungs causes bronchoconstriction . It increases the tone and motility of the gastrointestinal (GI) tract and is not contraindicated in patients with reflux. It causes vasodi-lation and would actually lower blood pressure in a hypertensive patient. It causes dysrhythmias in hyperthyroid patients.

Answer to Question 2

B
Women older than 50 years need 1200 mg of calcium per day. Patients should take only enough supplemental calcium to make up for the difference between what the diet provides and the RDA. This patient is getting 1800 mg/day. Excess supplemental calcium can increase risks for vascular calcification, MI, stroke, and kidney stones. She does not need to increase calcium intake. Supplementing with 10,000 units of vitamin D is indicated for documented vitamin D deficiency, which is not evident in this case.