Medical Surgical Asthma #2

Question

The nurse is performing an admission assessment for a hospitalized client with a diagnosis of asthma. The nurse questions the admitting order for ipratropium bromide (Atrovent) because the client has a history of which condition?

Answers

  1. Cushing disease.
    • Rationale:

      This answer is not correct because anticholinergics are not contraindicated in clients with a history of Cushing disease. This prescription would not need to be questioned.

  2. Edema.
    • Rationale:

      This answer is not correct because anticholinergics are not contraindicated in clients with edema. This prescription would not need to be questioned.

  3. Glaucoma.
    • Rationale:

      This answer is correct because Ipratropium bromide (Atrovent) is an anticholinergic, which is contraindicated with angle-closure glaucoma since it might raise intraocular pressure and inhibit aqueous humor flow. The nurse would need to contact the health care provider about the client’s history of glaucoma.

  4. Anticoagulation therapy.
    • Rationale:

      This answer is not correct because anticholinergics do not interfere with anticoagulation therapy. This prescription would not need to be questioned.

Overview

The focus of this question is prevention of critical potential complications for a client newly prescribed an anticholinergic medication. Anticholinergic medications can precipitate or worsen glaucoma due to pupillary dilation so the nurse would need to alert the provider about a history of glaucoma for the client newly prescribed an anticholinergic medication.

Explanation

Learning Outcomes

Ipratropium bromide is an inhaled anticholinergic medication used to treat bronchoconstriction in clients with asthma and other respiratory illnesses. It is normally used in combination with a short-acting beta agonist to reverse bronchoconstriction. Side effects of anticholinergic medications include dry eyes, dry mouth, blurred vision, and urinary retention. Anticholinergics are contraindicated in clients with glaucoma because through their mechanism of action, they can dilate the pupil which can lead to a pupillary block.

Test Taking Tip

It is important to know the most deadly/critical complications of medication classes when studying pharmacology.

Video Rationale