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","E","F"]
Explanation
A. Rebound hypotension is more commonly associated with abrupt withdrawal of beta-blockers rather than a direct side effect, so it is not typically included as a side effect to expect while on the medication.
B. Vomiting is not a common side effect associated with propranolol; the nurse would not educate the client on this.
C. Bradycardia is a known side effect of propranolol, as it is a beta-blocker that decreases heart rate, so clients should be educated about monitoring their heart rate.
D. Tremors can be related to withdrawal from beta-agonists rather than propranolol, which may alleviate tremors in some individuals; thus, it's not a common side effect of the medication.
E. Propranolol can mask the symptoms of hypoglycemia (e.g., tachycardia), making it important for clients with diabetes to be aware of this potential effect.
F. Bronchoconstriction can occur in clients with reactive airway diseases, as propranolol non-selectively blocks beta receptors, so clients should be educated about this risk, especially if they have asthma or other pulmonary conditions.
Correct Answer is C
Explanation
A. PT/INR is not the appropriate measure for heparin therapy, as heparin is monitored using activated partial thromboplastin time (aPTT). This response could mislead the client regarding treatment expectations.
B. While it may take time to reach therapeutic levels, this statement doesn't clarify that heparin is not a clot-dissolving agent.
C. Heparin prevents the extension of existing clots and the formation of new clots but does not actively dissolve clots already present.
D. This statement incorrectly suggests that immediate effects are seen, which is not the case as heparin's action involves prevention rather than dissolution.