A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H2 receptor antagonist (famotidine). Which of the following outcomes indicates that famotidine is therapeutic?

Choice A reason: Vasodilation is not the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can cause vasodilation by inhibiting the muscarinic receptors on the blood vessels, which normally cause vasoconstriction. However, this effect is not significant or consistent, and it does not improve the symptoms of bradycardia, which is a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the blood pressure and the peripheral pulses of the patient after administering atropine.

Choice B reason: Bronchodilation is not the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can cause bronchodilation by inhibiting the muscarinic receptors on the bronchial smooth muscle, which normally cause bronchoconstriction. However, this effect is not relevant or beneficial for the patient with symptomatic bradycardia, who does not have any respiratory problems. The nurse should assess the respiratory rate and the breath sounds of the patient after administering atropine.

Choice C reason: Increase in heart rate is the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can increase the heart rate by inhibiting the muscarinic receptors on the sinoatrial node and the atrioventricular node, which normally slow down the heart rate. This effect is desirable and beneficial for the patient with symptomatic bradycardia, who has a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the electrocardiogram and the heart rate of the patient after administering atropine.

Choice D reason: Diuresis is not the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can cause diuresis by inhibiting the muscarinic receptors on the bladder, which normally promote urination. However, this effect is not important or helpful for the patient with symptomatic bradycardia, who does not have any urinary problems. The nurse should measure the urine output and the specific gravity of the patient after administering atropine.

Choice A reason: This is correct. Hypertension is a contraindication for taking pseudoephedrine. Pseudoephedrine is a decongestant that shrinks the blood vessels in the nasal passages and relieves congestion. However, it can also increase the blood pressure and the heart rate, which can worsen hypertension and increase the risk of stroke, heart attack, or kidney damage. The nurse should advise the client to avoid pseudoephedrine and use other methods to relieve sinus congestion, such as saline nasal spray, steam inhalation, or humidifier.

Choice B reason: This is incorrect. Diverticulitis is not a contraindication for taking pseudoephedrine. Diverticulitis is a condition where small pouches in the colon become inflamed and infected. It can cause symptoms such as abdominal pain, fever, nausea, or constipation. Pseudoephedrine does not affect the colon or the inflammation directly, but it can cause dehydration, which can worsen constipation and diverticulitis. The nurse should advise the client to drink plenty of fluids and eat a highfiber diet to prevent constipation and diverticulitis.

Choice C reason: This is incorrect. Migraines are not a contraindication for taking pseudoephedrine. Migraines are severe headaches that are often accompanied by nausea, vomiting, or sensitivity to light and sound. They can be triggered by various factors, such as stress, hormones, or food. Pseudoephedrine does not cause migraines directly, but it can interact with some migraine medications, such as triptans, which are used to treat acute migraine attacks. The combination of pseudoephedrine and triptans can increase the blood pressure and the risk of serotonin syndrome, a serious condition that causes agitation, confusion, tremors, or seizures. The nurse should advise the client to check with their doctor before taking pseudoephedrine and triptans together.

Choice D reason: This is incorrect. Eczema is not a contraindication for taking pseudoephedrine. Eczema is a skin condition that causes dry, itchy, and inflamed skin. It can be caused by various factors, such as allergies, irritants, or genetics. Pseudoephedrine does not affect the skin or the inflammation directly, but it can cause dryness of the mucous membranes, such as the mouth, nose, or eyes. The nurse should advise the client to use a moisturizer, a lip balm, and artificial tears to prevent dryness and irritation of the skin and the mucous membranes.