Purpose: Discuss signs, symptoms, nursing care, and patient teaching
Quiz: At the end to test knowledge
Anticholinergic Effects
Medications Involved
Inhaled/nasal anticholinergics
Atropine
Antihistamines
Tricyclic antidepressants
Antipsychotic agents
Benztropine
Oxybutynin
Mechanism & Side Effects
Mechanism: Blocks acetylcholine effects
Side Effects:
Blurred vision
Dry mouth
Urinary retention
Constipation
Tachycardia
Photosensitivity
Hyperthermia
Mnemonic: "Can't see, can't pee, can't spit, can't poop"
Nursing Care
Monitor urine output (risk of urinary retention)
Monitor temperature (risk of hyperthermia)
Patient Teaching:
Increase fluid and fiber intake (prevent constipation)
Suck on hard candy (help with dry mouth)
Wear sunglasses (help with photosensitivity)
Avoid extreme heat (prevent overheating)
Medications Increasing Bleeding Risk
Medications Involved
Heparin and enoxaparin
Warfarin and factor Xa inhibitors
Platelet aggregation inhibitors
Thrombin inhibitors
Thrombolytics
Many antineoplastic agents
Signs and Symptoms of Bleeding
Coffee ground emesis
Black tarry stools
Hematuria (blood in urine)
Oozing at the gum line
Bruising
Nursing Care
Limit venipunctures and IM injections
Use smallest needle possible if injections are necessary
Implement fall precautions
Patient Teaching:
Use a soft-bristle toothbrush
Use an electric razor
Seek immediate medical attention after head trauma
Medications Increasing Infection Risk
Medications Involved
Corticosteroids
Atypical antipsychotic agents
Disease-modifying antirheumatic drugs
Many antineoplastic agents
Nursing Care
Implement protective isolation or neutropenic precautions
Private room with dedicated equipment
No live flowers or plants
Screen visitors for signs of illness
Notify provider immediately for signs of infection
Monitor white blood cell count and temperature
Patient Teaching:
Avoid crowded areas and contact with sick people
Perform frequent and thorough hand hygiene
Avoid gardening and cleaning cat boxes
Cook foods thoroughly to prevent foodborne illness
Quiz Questions
Question: Your patient should be advised to increase their fiber and fluid intake, suck on hard candy, and wear sunglasses to address what type of medication side effect?
Answer: Anticholinergic effects
Question: Coffee ground emesis and black tarry stools may be indicative of what medication side effect?
Answer: Bleeding
Question: What kind of precautions should be implemented for a patient on an immunosuppressant?
Answer: Protective isolation or neutropenic precautions