A client is taking cyclobenzaprine (Flexeril) for acute muscle spasms of the back. The nurse educates the client on which possible anticholinergic side effects associated with this medication? (Select all that apply)
Decreased Urination
Diarrhea
Dry Mouth
Tachycardia
Excessive Lacrimation
Excessive Sweating
Correct Answer : A,C,D
A. Decreased urination is an anticholinergic side effect due to the medication's action on the bladder.
B. Diarrhea is not an anticholinergic side effect; in fact, anticholinergics typically cause constipation.
C. Dry mouth is a common anticholinergic side effect, resulting from reduced saliva production.
D. Tachycardia can occur as an anticholinergic effect due to decreased vagal tone.
E. Excessive lacrimation is not associated with anticholinergic effects; it is the opposite, as anticholinergics usually lead to dry eyes.
F. Excessive sweating is contrary to anticholinergic effects, which often result in decreased sweating.
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Correct Answer is B
Explanation
A. Chlorpheniramine is a first-generation antihistamine and may cause sedation and other side effects due to its ability to cross the blood-brain barrier.
B. Cetirizine is a second-generation antihistamine that is less likely to cause sedation and is used to relieve symptoms of allergic rhinitis.
C. Montelukast is a leukotriene receptor antagonist, not an antihistamine, and is used for allergic rhinitis and asthma.
D. Diphenhydramine is a first-generation antihistamine known for its sedative effects and is often used for allergies but is not classified as a second-generation antihistamine.
Correct Answer is B
Explanation
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.