If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor.
Which doctor’s order should the nurse anticipate?

Dry mouth is a common adverse effect of anticholinergic agents used to treat overactive bladder syndrome (OAB).Anticholinergic agents prevent involuntary contractions of the bladder detrusor muscle by blocking the action of acetylcholine, a neurotransmitter that stimulates the muscle.However, anticholinergics are not tissue specific, and they also affect other parts of the body where acetylcholine is involved, such as the salivary glands, the gastrointestinal tract, and the eyes.

Choice B is wrong because restlessness is not a typical side effect of anticholinergic agents.In fact, anticholinergics can cause sedation and drowsiness in some people.

Choice C is wrong because increased salivation is the opposite of what anticholinergics do.Anticholinergics reduce the secretion of saliva, causing dry mouth.

Choice D is wrong because diarrhea is also the opposite of what anticholinergics do.Anticholinergics slow down the movement of the gastrointestinal tract, causing constipation.

Some other possible adverse effects of anticholinergic agents include blurred vision, urinary retention, confusion, memory impairment, and increased risk of dementia and mortality.

Therefore, these drugs should be used with caution and under medical supervision.

Digoxin is a medication that can help the heart pump more blood and slow down the heart rate in certain conditions, such as heart failure and atrial fibrillation.However, digoxin has a narrow therapeutic range, which means that too much or too little of it can be harmful.The therapeutic range of digoxin levels in the blood is 0.5-2 ng/mL, and the toxic level is >2.4 ng/mL.Digoxin should be held if the resting apical pulse of an infant is <90 bpm, an older child is <70 bpm, or an adult is <60 bpm.A pulse of 48/min in an adult is too low and could indicate digoxin toxicity, which can cause life-threatening arrhythmias. Therefore, the nurse should withhold the dose and notify the health care provider immediately.

Choice B is wrong because notifying the health care provider and monitoring the patient’s vital signs are not enough.

The nurse should also withhold the dose to prevent further exposure to digoxin.

Choice C is wrong because rechecking the pulse, making sure to count for 1 full minute, is not necessary.The nurse should already have counted the pulse for 1 full minute before administering digoxin, as per standard procedure.

Choice D is wrong because administering the dose could worsen the patient’s condition and increase the risk of digoxin toxicity and arrhythmias.