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 C
Explanation
A. Macrolides, such as azithromycin and erythromycin, have a low cross-reactivity with penicillin and are typically safe alternatives for those with penicillin allergies.
B. Sulfonamides are not structurally similar to penicillins and generally do not have cross-sensitivity issues with penicillin allergies.
C. Cephalosporins share a similar beta-lactam structure to penicillins, which can result in cross-sensitivity in some individuals with a penicillin allergy. For this reason, they should be avoided or used with caution in these clients.
D. Tetracyclines have a different structure from penicillins and are usually safe for clients with penicillin allergies.
Correct Answer is C
Explanation
A. A pulse oximetry of 92% indicates mild hypoxia but does not directly contraindicate the use of verapamil.
B. A respiratory rate of 12 is within the normal range for adults and does not indicate a need to hold the medication.
C. A pulse of 78 is within the normal range but should be assessed in the context of the client’s overall condition; however, if the pulse were significantly lower (e.g., <60 bpm), it would necessitate holding the medication due to the risk of bradycardia.
D. A history of myocardial infarction a week ago would warrant caution but is not an absolute reason to hold verapamil unless other contraindications are present, as verapamil can be beneficial for managing hypertension post-MI.