Page 1902 - Saunders Comprehensive Review For NCLEX-RN

8. Dry eyes
9. Gastric distress
10. Headache
11. Tachycardia
12. Urinary retention
C. Nursing considerations
1. Extended-release capsules should not be split, chewed,
or crushed.

2. Tolterodine should be used cautiously in

clients with narrow-angle glaucoma.

3. Do not administer oxybutynin to clients with

known hypersensitivity, gastrointestinal or
genitourinary obstruction, glaucoma, severe colitis, or
myasthenia gravis.
4. Do not administer propantheline to clients

with narrow-angle glaucoma, obstructive uropathy,
gastrointestinal disease, or ulcerative colitis.
5. Instruct the client to avoid hazardous activities
because of the effects of dizziness and drowsiness.
6. Monitor intake and output.

7. Provide gum or hard candy for dry mouth.

8. Monitor for signs of toxicity (CNS stimulation) such as
hypotension or hypertension, confusion, tachycardia,
flushed or red face, signs of respiratory depression,
nervousness, restlessness, hallucinations, and
irritability.

Antispasmodic medications used to treat overactive bladder

(urge incontinence) should not be used by clients diagnosed with open-
angle glaucoma. These medications will block the flow of intraocular
fluid and raise the intraocular pressure. This may cause permanent
damage to the optic nerve.
VI. Cholinergics
A. Description: Bethanechol chloride is a cholinergic used to increase
bladder tone and function and to treat nonobstructive urinary
retention and neurogenic bladder.
B. Side and adverse effects
1. Headache
2. Hypotension
3. Flushing and sweating
4. Increased salivation
5. Nausea and vomiting

1902