Nursing Considerations for Patients Receiving Anticholinergic Agents 抗胆碱能药使用者的护理考虑
Assessment: History and Examination 评估：病史和体检
• Assess for contraindications or cautions: any known allergies to these drugs to avoid hypersensitivity reactions; GI depression or obstruction, urinary hesitancy or obstruction, benign prostatic hypertrophy, or glaucoma, which may be exacerbated by the peripheral anticholinergic effect of the drug; cardiac arrhythmias, hypertension, or hypotension, which may be increased due to the dominance of sympathetic stimulatory activity due to blockage of parasympathetic activity; myasthenia gravis, which may be exacerbated by blockage of acetylcholine receptors; current status related to pregnancy or lactation due to risk of fetal or infant adverse effects; hepatic dysfunction, which could interfere with drug metabolism and increase risk for toxicity; and exposure to a hot environment, which may block the individual’s reflex sweating.
• Perform a physical assessment to determine baseline data for determining the effectiveness of the drug and the occurrence of adverse effects associated with drug therapy.
进行体格评估，确定评估药物效果和药物疗法相关不良事件发生率所需的基线资料。
• Assess level of orientation and neurological status, including affect, reflexes, bilateral grip strength, gait, tremors, and spasticity, to evaluate any CNS effects.
评估定向水平和神经学状况，包括情感、反射、双手握力、步态、震颤和痉挛状态，评价CNS效应。
• Monitor pulse, blood pressure, and cardiac output to evaluate for possible adverse effects related to blocking of suppressive action on the heart.
监测脉搏、血压、心排血量，评价与心脏抑制作用阻断相关的可能不良效应
• Auscultate bowel sounds to evaluate GI motility and detect possible indications of paralytic ileus.
听诊肠鸣音，评价GI能动性，发现可能的麻痹性肠梗阻指征。
• Assess urine output and palpate bladder to determine adequate renal and bladder function.
评估尿排量、触诊膀胱，确定充分的肾和膀胱功能。
• Monitor the results of laboratory tests such as renal and liver function tests to determine the need for possible dose adjustment and identify potential toxic effects.
监测实验室检查结果，如肾和肝功能试验，明确可能的剂量调整需要，确认潜在的毒性效应。
★Vocabulary ★
urinary hesitancy – 排尿犹豫
urinary obstruction – 尿路梗阻
benign – a. 良性的
glaucoma – n. 青光眼
perform – v. 实施，进行
affect – n. 情感
spasticity – n. 痉挛状态
1. Remembering that anticholinergics block the effects of PNS, the nurse would question an order for an anticholinergic drug for patients with which of the following conditions?
A. Biliary spasms
B. Bradycardia
C. Glaucoma
D. Asthma 2. Which client diagnosed with Parkinson’s disease should the nurse question administering benztropine?
A. The client diagnosed with CHF.
B. The client who has had a myocardial infarction.
C. The client diagnosed with glaucoma.
D. The client who is undergoing hip replacement surgery.
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案 Answers
1. C. Glaucoma
All other options are indications for atropine 2. C. The client diagnosed with glaucoma
Anticholinergic medications, such as benztropine (Cogentin), block cholinergic receptors in the eye and may precipitate or aggravate glaucoma.
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