Chapter 30 - Adrenergic Agonists
Which would the nurse identify as a naturally occurring catecholamine? Dobutamine Ephedrine Metaraminol Dopamine
Dopamine Explanation:Dopamine is a naturally occurring catecholamine. Dobutamine, ephedrine, and metaraminol are synthetic catecholamines.
Which client is most likely to benefit from the administration of an adrenergic agonist? A woman who is in labor and may require a cesarean section A woman who has been admitted with a suspected ischemic stroke A man who has a diagnosis of primary hypertension A man who is in cardiogenic shock following a myocardial infarction
A man who is in cardiogenic shock following a myocardial infarction
A patient has been prescribed dopamine. Which intervention should the nurse perform during the drug regimen? Dilute dopamine with sodium bicarbonate. Maintain a fixed rate of administration. Administer dopamine only via IV route. Monitor blood pressure every half hour.
Administer dopamine only via IV route
A client is being treated for asthma. What would the nurse expect to administer? Alpha- and beta-adrenergic agonist Alpha-specific adrenergic agonist Beta-1-specific adrenergic agonist Beta-2-specific adrenergic agonist
Beta-2-specific adrenergic agonist
What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction? Narcotic antagonist Beta-adrenergic blockers Neuromuscular blocking agent Sympathomimetic agents
Beta-adrenergic blockers
A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient? Sleeplessness Elevated temperature Urinary retention Cardiac arrhythmias
Cardiac arrhythmias
A 21-year-old man experienced massive trauma and blood loss during a motorcycle accident and has been started on a dopamine infusion upon his arrival at the hospital. In light of this drug treatment, what assessment should the care team prioritize? Arterial blood gases Respiratory assessment Cardiac monitoring Monitoring of intracranial pressure
Cardiac monitoring
A nurse is caring for an elderly patient who is to be administered isoproterenol. Which change monitored in the patient should the nurse report immediately to the primary health care provider? Changes in temperature Changes in pulse rate Changes in glucose level Changes in appetite
Changes in pulse rate
Contraindications to adrenergic drugs include what conditions? (Select all that apply.) Cardiac dysrhythmias Hyperthyroidism Hypersensitivity to sulfites Hypersensitivity to penicillins Hypotension
Correct response: Cardiac dysrhythmias Hyperthyroidism Hypersensitivity to sulfites Explanation:Contraindications to adrenergic drugs include cardiac dysrhythmias, angina, hypertension, hyperthyroidism, cerebrovascular disease, narrow-angle glaucoma, and hypersensitivity to sulfites.
Which herbs has been removed from most weight-loss medications due to potential legal liability? Rose hips Gingko Ginseng Ephedra
Ephedra Explanation: Ephedra has serious adverse reactions, such as hypertension and irregular heart beat. These side effects have been associated with stroke and heart attacks. The Food and Drug Administration has warnings against taking weight-loss pills that have ephedra in them. Gingko, ginseng, and rose hips have not had these serious side effects.
An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist? Phenylephrine Epinephrine Albuterol Terbutaline
Epinephrine
An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist? Terbutaline Albuterol Phenylephrine Epinephrine
Epinephrine
A nurse would instruct a patient to apply a clonidine patch at which frequency? Every day Every 5 days Every other day Every 7 days
Every 7 days Explanation:Clonidine transdermal has a duration of action of 7 days, so it needs to be replaced only every week.
An increased dosage of digoxin would be needed if the patient is also taking midodrine. True False
False
Which assessment finding would indicate to the nurse that the administered isoproterenol is effective? Bronchoconstriction Improved cardiac contractility Uterine contraction Decreased heart rate
Improved cardiac contractility
Which assessment finding would indicate to the nurse that the administered isoproterenol is effective? Improved cardiac contractility Uterine contraction Bronchoconstriction Decreased heart rate
Improved cardiac contractility
An adrenergic drug would be prescribed to produce what physiological effect? decreased blood pH decreased respiratory rate increased heart rate urine concentration
Increased heart rate
A patient is receiving salmeterol. The nurse would expect this drug to be given by which route? Oral Intravenous Intramuscular Inhalation
Inhalation
A client has been prescribed dopamine. Which action would be most appropriate for the nurse to do? Administer dopamine intramuscularly. Monitor BP every 10 minutes until desired level is achieved. Inspect the needle site and surrounding tissues for leakage. Mix dopamine with sodium bicarbonate.
Inspect the needle site and surrounding tissues for leakage.
A home care nurse is visiting a patient to assess blood pressure and heart rate. The patient's grandson has a large amount of pseudoephedrine (Sudafed) in the kitchen. For what might the nurse suspect the patient's grandson is using the pseudoephedrine? Treatment of bronchial asthma Methamphetamine production Treatment of sinusitis To increase appetite
Methamphetamine production Explanation:Pseudoephedrine and ephedrine are ingredients used in making methamphetamine, a highly addictive and illegal drug of abuse. Pseudoephedrine is used in the treatment of bronchospasm but is not the drug of choice. Pseudoephedrine is used in the treatment of sinusitis, but, in large quantities, the nurse should suspect methamphetamine production. Pseudoephedrine will increase basal metabolic rate but is not the drug of choice to increase appetite.
Epinephrine is contraindicated in clients with which diseases or disorders? Narrow-angle (or closed-angle) glaucoma Bronchoconstriction Asthma Hypotension
Narrow-angle (or closed-angle) glaucoma
Epinephrine can be administered by multiple routes. Which is not an appropriate route? Subcutaneous Intramuscular Oral Intravenous
Oral
A male client is diagnosed with type 2 diabetes, asthmatic bronchitis, benign prostatic hyperplasia, and hyperlipidemia. He takes an adrenergic medication as part of his daily drug regimen. As part of his education plan, the nurse would teach the client to observe for which signs and symptoms? Muscle cramping Constipation Painful urination Indigestion
Painful urination
A client who is in shock has been prescribed a dopamine intravenous infusion. What component of the client's existing medication regimen most increases the client's risk for adverse effects? Vitamin B6 Albuterol Phenelzine Levothyroxine
Phenelzine Explanation:Phenelzine is a monoamine oxidase (MAO) inhibitor; MAO is partially responsible for the deactivation of norepinephrine in synapses of the sympathetic nervous system and alterations in its levels can affect norepinephrine levels. Albuterol, levothyroxine and vitamin B6 are not reported to create a risk for drug-drug interactions.
Drugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following? Antiadrenergic drugs Anticholinergic drugs Sympatholytics Sympathomimetics
Sympathomimetics
While educating a client on the use of midodrine (ProAmatine) the nurse should tell the client to report which changes? (Select all that apply.) Bradycardia Constipation Fine tremor Vision changes Difficulty urinating
Vision changes Bradycardia Difficulty urinating Client taking midodrine should be told by the nurse to report any of the following reactions: vision changes, pounding head when lying down, bradycardia, or difficulty urinating.
A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action? measure urine output. assess heart rate. monitor respiratory rate. check blood glucose level.
assess heart rate
A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to: decrease blood pressure. decrease heart rate. increase body temperature. increase blood pressure.
increase blood pressure.
The client is given epinephrine for an exacerbation of asthma. What response to the medication would the nurse expect? Increased heart rate and respiratory rate Decreased inflammation and increased heart rate Bronchodilation and decreased heart rate Increased ease of breathing and increased heart rate
increased ease of breathing and increases heart rate.
Adrenergic drugs mimic the effects of stimulating what part of the nervous system? parasympathetic sympathetic central autonomic
sympathetic
Phentolamine is the agent used to treat extravasation of dobutamine. True False
True Explanation:Maintain phentolamine on standby in case extravasation occurs.
