A nurse administers medications to older adults in a long-term care facility. Which of the following actions is most appropriate when the client with dementia is newly prescribed an antimuscarinic agent for urge urinary incontinence?
A) Administer with a full glass of water
B) Assess the client for drooling and diarrhea
C) Monitor the client closely for worsening cognitive impairment
D) Toilet the client before administering the medication
Ans: C
Antimuscarinic agents are used for urge urinary incontinence. Oxybutynin is the medication most commonly associated with cognitive impairment, but all antimuscarinic agents need to be used with caution in older adults with preexisting dementia. These medications have the same adverse effect profile as other anticholinergics, such as dry mouth, constipation, blurred vision, and mental changes. There is no need to toilet before, water is important, but cognition is the priority.
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