An older adult patient who takes trihexyphenidyl (Artane) for drug-induced parkinsonism begins taking diphenhydramine (Benadryl) for cold symptoms. The nurse should carefully monitor this patient for
a. polyuria.
b. tachycardia.
c. constipation.
d. hypothermia.
B
An anticholinergic effect on the vagus nerve causes tachycardia by removing the braking effect on the sinoatrial node. The additive effects of trihexyphenidyl and diphenhydramine would be likely to produce tachycardia, which could lead to cardiac decompensation in an older adult. In terms of priority of problems, hyperthermia may occur later, after toxic levels of anticholinergics had been ingested; constipation would be less life-threatening than cardiac decompensation. Anticholinergics cause urinary retention, not polyuria.
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