The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?
Irritable bowel disease
Glaucoma
Asthma
Hypertension
The Correct Answer is B
A) Irritable bowel disease: Benztropine is an anticholinergic medication that can reduce gastrointestinal motility, which might exacerbate constipation. However, irritable bowel disease (IBD) is not a contraindication for using benztropine. The drug is more likely to cause concern in conditions where smooth muscle relaxation could worsen symptoms of constipation, but it is not typically withheld due to IBD alone.
B) Glaucoma: Glaucoma, particularly narrow-angle glaucoma, is a contraindication for benztropine use. Benztropine, as an anticholinergic agent, can cause pupil dilation (mydriasis), which can increase intraocular pressure and worsen glaucoma. This is a critical concern for patients with glaucoma, and the healthcare provider should be notified before administering the drug.
C) Asthma: While benztropine can have mild anticholinergic effects that may cause dryness of the respiratory tract, it is not a contraindication for asthma. Beta-agonist inhalers are more commonly prescribed to manage bronchospasm, but the use of benztropine in asthma is not typically harmful unless the patient is experiencing severe respiratory distress. Asthma would not be a primary concern when administering this medication.
D) Hypertension: Benztropine does not directly affect blood pressure in a way that would be a concern for someone with hypertension. While it may cause some mild autonomic changes (like dry mouth or dizziness), hypertension is not a contraindication for the medication. Therefore, there is no specific need to notify the healthcare provider due to a history of hypertension.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Reversal of bronchoconstriction: Narcotic antagonists are not used to reverse bronchoconstriction. Bronchoconstriction is typically managed with bronchodilators (such as beta-agonists) or corticosteroids. Narcotic antagonists, such as naloxone, specifically counteract the effects of opioids, not respiratory conditions like bronchoconstriction.
B) Reversal of tachycardia: Narcotic antagonists do not have an effect on reversing tachycardia. Tachycardia may result from various conditions, including stimulant use, dehydration, or heart conditions. Treatment for tachycardia typically involves addressing the underlying cause, such as using beta-blockers for cardiac issues, but not narcotic antagonists.
C) Treatment of alcohol dependence: While certain medications, like disulfiram or acamprosate, are used to treat alcohol dependence, narcotic antagonists are not typically indicated for alcohol dependence. Narcotic antagonists, such as naloxone, are primarily used for opioid overdose or dependence, not for alcohol use disorders.
D) Treatment of narcotic dependence: Narcotic antagonists, such as naloxone, are prescribed in the treatment of narcotic (opioid) dependence. These medications work by blocking the effects of opioids at the receptor sites, thereby preventing the "high" associated with opioid use. They are particularly useful in treating opioid overdoses and can also be used in the management of opioid addiction as part of a comprehensive treatment plan.
Correct Answer is A
Explanation
A) Celecoxib (Celebrex):
Celecoxib is a selective COX-2 inhibitor that targets the cyclooxygenase-2 enzyme, which is primarily responsible for inflammation, pain, and fever. COX-2 inhibitors tend to cause less gastrointestinal irritation compared to nonselective NSAIDs like aspirin, which block both COX-1 and COX-2 enzymes. Because aspirin is causing gastrointestinal upset, switching to Celecoxib, which is less likely to irritate the stomach lining, may be an appropriate option to prevent myocardial infarction while minimizing gastrointestinal discomfort.
B) Enteric-coated aspirin:
Enteric-coated aspirin is designed to dissolve in the small intestine rather than the stomach, which may reduce some gastrointestinal irritation. However, it does not eliminate the risk entirely, and it still functions as a COX-1 inhibitor. If the patient is already experiencing gastrointestinal upset, simply switching to enteric-coated aspirin may not be sufficient to alleviate the discomfort, and other options should be considered.
C) Nabumetone (Relafen):
Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) with some COX-2 selectivity. While it may cause less gastrointestinal upset than non-selective NSAIDs like aspirin, it is still an NSAID and carries a risk of gastrointestinal side effects, especially with prolonged use.
D) A COX-2 inhibitor:
While COX-2 inhibitors, including Celecoxib, are typically effective in reducing inflammation and pain with fewer gastrointestinal side effects than traditional NSAIDs, the term "a COX-2 inhibitor" could refer to various drugs, and Celecoxib (Celebrex) is the most commonly used.
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