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CHOLINERGIC DRUGS (ATROPINE (INDICATIONS (Prevention of nausea, vomiting,…

- - - - Assess for contraindications or cautions
      - Establish baseline physical assessment to monitor for any potential adverse effects.
      - Assess neurological status (e.g., orientation, affect, reflexes) to evaluate any CNS effects.
      - Assess abdomen (e.g., bowel sounds, bowel and bladder patterns, urinary output) to evaluate for GI and GU adverse effects.
      - Monitor laboratory test results to determine need for possible dose adjustments and to identify potential toxicity.
    - - Acute pain related to GI, CNS, GU, and CV effects
      - Decreased cardiac output related to CV effects
      - Impaired urinary elimination related to effects on the bladder
      - Constipation related to GI effects
    - - Ensure proper administration of the drug to ensure effective use and decrease the risk of adverse effects.
      - Monitor patient response (e.g., blood pressure, ECG, urine output) for changes that may indicate need to adjust dose.
      - Provide comfort measures (e.g., sugarless lozenges, lighting control, small and frequent meals) to help patient cope with drug effects.
      - Provide patient education about drug effects and warning signs to report to enhance knowledge about drug therapy and promote compliance
    - - Monitor patient response to therapy (improvement in condition being treated).
      - Monitor for adverse effects (e.g., photophobia, heat intolerance, urinary retention).
      - Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
      - Monitor patient compliance to drug therapy.
- - - - increased GI activity and secretions
      - increased bladder tone,
      - bronchoconstriction and increased bronchial mucus secretion,
      - relaxation of GI and bladder sphincters and pupil constriction
      - vasodilation,
      - slowed heart rate and decreased myocardial contractility
  - - - Assess for contraindications or cautions (e.g. history of allergy to drug, GI obstruction, pregnancy or lactation status, etc.) to avoid adverse effects.
      - Establish baseline physical assessment to monitor for any potential adverse effects.
      - Assess orientation, affect, reflexes to monitor CNS drug effects.
      - Assess vital signs, especially pulse and blood pressure to monitor for possible excess stimulation of the cardiac system.
      - Assess abdomen, auscultating for bowel sounds and palpating for distention.
      - Monitor intake and output, noting any complaints of urinary urgency to monitor for drug effects on the urinary system.
    - - Acute pain related to GI effects
      - Decreased cardiac output related to CV effects
      - Impaired urinary elimination related to effects on the bladder
    - - Administer oral drug on empty stomach to decrease nausea and vomiting.
      - If drug is given intravenously, administer slowly to avoid severe cholinergic effects.
      - Monitor patient response closely (e.g., blood pressure, ECG, urine output)
      - Maintain a cholinergic-blocking drug on standby
      - Discontinue drug if excessive salivation, diarrhea, emesis
      - Provide safety precautions if the patient reports poor visual acuity in dim light to prevent injury.
      - Provide comfort measures (e.g., quiet room, support and relaxation measures)
      - Provide patient education about drug effects and warning signs
    - - Monitor patient response to therapy (improvement in condition being treated).
      - Monitor for adverse effects (e.g. GI upset, CNS changes, CV changes).
      - Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
      - Monitor patient compliance to drug therapy.