Pharm Chapter 19

The patient has been placed on an adrenergic-blocking drug and notifies the nurse that the patient will be relocating to Florida. What is the most important instruction for the nurse to give this patient? Notify all health care providers of the relocation. Make certain that all prescriptions are refilled before relocating. Make a copy of all relevant medical records before leaving the area. Monitor blood pressure closely because you will be exposed to a hot climate.

Monitor blood pressure closely because you will be exposed to a hot climate.

The nurse recognizes that the patient who is taking an adrenergic-blocking drug understands the importance of avoiding other substances that may interact with the medication when the patient makes which statement? "I should limit my fluid intake while taking this medication." "I should avoid drinking my morning coffee while taking this drug." "There's no need to stop eating chocolate while I'm on this medication." "One glass of red wine with meals will not interfere with the medication."

"I should avoid drinking my morning coffee while taking this drug."

A patient reports some adverse effects after taking beta blockers. What is the priority complaint the nurse should address? "I check my sugar more often because it has been high." "I feel dizzy when standing quickly, so I have to get up slowly." "I stopped taking my medicine yesterday because it made me feel tired." "My migraines are not 100% better, so I don't think the medicine is working."

"I stopped taking my medicine yesterday because it made me feel tired."

The patient verbalizes understanding of the nurse's teaching of adrenergic-blocking medication side effects when what statement is made? "I'll tell my health care provider if I feel tired in the evenings." "I will notify the health care provider if I gain 5 pounds in a week." "I should report to urgent care if I feel dizzy when I stand up too fast." "I'll call my health care provider if I lose more than 1 pound in a month."

"I will notify the health care provider if I gain 5 pounds in a week."

The nurse notes that an accidental overdose of prazosin has been given orally. What is the nurse's priority action? Auscultate breath sounds. Administer activated charcoal. Check the patient's blood pressure. Administer the vasopressor antidote.

Check the patient's blood pressure.

A patient with a new prescription for propranolol tells the nurse she has a history of asthma. What is the nurse's priority action? Notify the patient's health care provider. Tell the patient to change positions slowly. Teach the patient how to take her blood pressure. Inform the patient to carry a rescue inhaler at all times.

Notify the patient's health care provider.

Which beta blockers show alpha receptor-blocking activity at higher doses? Pindolol Labetalol Carvedilol Acebutolol Penbutolol

Labetalol Carvedilol

The patient is admitted with supraventricular tachydysrhythmias. The nurse anticipates that the patient will be placed on which medication? Atenolol Esmolol Labetalol Carvedilol

Esmolol

The nurse observes redness and swelling on the patient's forearm where an intravenous (IV) epinephrine injection was made. The nurse anticipates administration of which medication to counteract the effects on the surrounding tissue at the IV site? Labetalol Doxazosin Phentolamine Norepinephrine

Phentolamine

Which outcome indicates effective treatment for a pregnant patient who is on esmolol therapy? The patient will no longer experience a rapid heart rhythm. The patient will no longer experience a decreased resistance to urinary outflow. The patient will no longer experience pulsating headaches on one side of the head. The patient will no longer experience numbness of the nose, fingers, and ears in response to cold.

The patient will no longer experience a rapid heart rhythm.

While caring for a patient on dopamine therapy, the nurse finds extravasation of medication. Why would the primary health care provider order the nurse to inject phentolamine into the patient? To induce peripheral vasodilation To reduce myocardial stimulation To reduce myocardial contractility To induce peripheral vasoconstriction

To induce peripheral vasodilation

Which alpha blocker can be used to treat both hypertension and benign prostatic hyperplasia (BPH)? Prazosin Alfuzosin Terazosin Tamsulosin

Terazosin

During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. What is the nurse's best action? Ask the patient to lie down and rest. Administer prescribed nitroprusside. Administer prescribed phentolamine. Assess the patient's dietary intake of sodium and fluid.

Administer prescribed phentolamine.

The nurse should recognize that a 68-year-old man taking tamsulosin is at risk for developing severe hypotension if he does what? Continues his daily exercise routine Also takes medication for erectile dysfunction Sits at the bedside for 1 minute before standing Consumes his usual one alcoholic beverage a day

Also takes medication for erectile dysfunction

patient has been taking metoprolol and tells the home care nurse, "I can't afford this medication any more, and I stopped it yesterday." What is the nurse's priority action? Assess the patient's blood pressure. Refer the patient to the social worker. Call the drug company to ask for assistance. Teach the patient not to discontinue the medication abruptly.

Assess the patient's blood pressure.

After administering a beta blocker to an adult patient, the nurse expects which vital sign results? BP 150/85, P 90, RR 20 BP 170/90, P 85, RR 18 BP 90/50, P 110, RR 18 BP 120/70, P 60, RR 16

BP 120/70, P 60, RR 16

The nurse is caring for a patient diagnosed with heart failure and chronic obstructive pulmonary disease (COPD). The patient is ordered carvedilol. What is the nurse's primary intervention? Maintain the patient on intake and output. Assess the heart rate before administration. Make sure the patient is on telemetry monitoring. Call the health care provider to request a different medication.

Call the health care provider to request a different medication.

The patient is being treated for heart failure. Based on this diagnosis, the nurse anticipates that the patient will be treated with which adrenergic-blocking drug? Esmolol Carvedilol Metoprolol Propranolol

Carvedilol Carvedilol is used to treat heart failure, angina, and hypertension. Esmolol (Brevibloc) is a very strong short-acting beta1 blocker. It is primarily used in acute situations to provide rapid temporary control of the ventricular rate in patients with supraventricular tachydysrhythmias. Metoprolol (Lopressor) is the most commonly used beta1 blocker. Recent studies of metoprolol have shown increased survival in patients given the drug after they have experienced an MI. Propranolol (Inderal) is the prototypical nonselective beta1- and beta2-blocking drug. Propranolol has been used for the treatment of tachydysrhythmias associated with cardiac glycoside intoxication and for the treatment of hypertrophic subaortic stenosis, pheochromocytoma, thyrotoxicosis, migraine headache, essential tremor, and many other conditions.

The patient is taking a beta blocker drug. The patient tells the nurse that she has been taking antacids frequently. The nurse recognizes that the interaction of the beta blocker and the antacid may have which result? Increased activity of the antacid Decreased activity of the antacid Increased activity of the beta blocker Decreased activity of the beta blocker

Decreased activity of the beta blocker

The patient is prescribed a beta blocker medication and is also taking an aluminum hydroxide-type antacid as part of his treatment regimen. The nurse anticipates that this interaction will result in what? Increased beta blocker activity Increased effect of the antacid Decreased beta blocker activity Decreased effect of the antacid

Decreased beta blocker activity

Which assessment is most important for a nurse to report to the health care provider for a patient receiving labetalol intravenously? Potassium level 4.1 Electrocardiogram changes Sodium level 140 mEq/mL Blood pressure 120/70 mmHg

Electrocardiogram changes Electrocardiogram changes are the most important assessment findings to report because these changes can result in the most adverse outcomes for the patient. The potassium and sodium levels are normal. The blood pressure is expected to be decreased after administration of a beta blocker.

A patient received the first dose of an alpha-blocking medication 15 minutes ago. The charge nurse must intervene when observing a nursing student perform which action? Listening for the patient's apical pulse Encouraging the patient to ambulate in the hallway Taking the patient's blood pressure while the patient is lying down Telling the patient to eat the chicken on the lunch tray before the pudding

Encouraging the patient to ambulate in the hallway

The patient has been receiving dopamine in an intravenous infusion. The nurse notes that the health care provider has ordered phentolamine to be administered. What does the nurse recognize the patient is most likely experiencing? Toxicity Overdosage Extravasation Anaphylaxis

Extravasation

A nurse is preparing to administer a beta blocker to a patient. The nurse recognizes that beta blockers are used to treat which conditions? Hypertension Angina pectoris Heart failure (HF) Sinus bradycardia Cardiogenic shock Chronic obstructive pulmonary disease (COPD)

Hypertension Angina pectoris Heart failure (HF)

The nurse knows that alpha blockers may be prescribed to treat which conditions? Asthma Hypertension Cardiac arrest Raynaud's disease Benign prostatic hyperplasia

Hypertension Raynaud's disease Benign prostatic hyperplasia

The patient is prescribed a beta blocker medication and is also taking a diuretic as part of his treatment regimen. The nurse anticipates that this interaction will result in what? Decreased urination Decreased heart block Increased hypotension Increased hypertension

Increased hypotension

The nurse is monitoring a patient's vital signs on each visit that she makes to a health clinic. The patient has started treatment with an adrenergic-blocking drug. What is the nurse's highest priority? Count the radial pulse for 1 full minute. Count the patient's respiratory rate for 1 minute. Measure both supine and standing blood pressures. Take the patient's temperature by both the oral and axillary routes.

Measure both supine and standing blood pressures.

A patient who is taking beta blockers exhibits the following signs: BP 130/75, P 80, RR 18, tremors, irritability, and diaphoresis. What is the nurse's priority action? Obtain a blood glucose level. Take apical pulse for 1 full minute. Offer the patient a cup of orange juice. Check blood pressure in sitting and lying positions.

Obtain a blood glucose level. Beta blockers can mask signs of hypoglycemia such as tachycardia. Other signs of hypoglycemia include tremors, irritability, and diaphoresis. The nurse should first check this patient's blood glucose level before offering orange juice. Assess before intervening per the nursing process. Checking a blood glucose level takes priority over obtaining further blood pressure and an apical pulse.

Which of these outcomes would be most appropriate to establish for a patient who is taking a selective alpha 1 receptor blocker? Patient reports no difficulty breathing or shortness of breath. Patient's urine output is less than 240 mL in an 8-hour period. Patient's heart rate is >80 beats per minute when ambulating. Patient's systolic blood pressure readings are <140 mm Hg and >110 mm Hg.

Patient's systolic blood pressure readings are <140 mm Hg and >110 mm Hg.

A patient complains of numbness of the nose, toes, fingers, and ears in response to cold. The clinical reports reveal narrowing of arteries, causing vasoconstriction. Which medication does the nurse expect to be beneficial? Terazosin Tamsulosin Phentolamine Phenoxybenzamin

Phenoxybenzamine Numbness of the nose, toes, fingers, and ears in response to cold indicates Raynaud's disease. In this disease, narrowing of small arteries occurs, leading to vasoconstriction. Phenoxybenzamine is an alpha blocker that causes vasodilation of the arteries. Therefore the nurse expects phenoxybenzamine to be beneficial. Terazosin is a selective alpha 1 antagonist used to treat hypertension. Tamsulosin is a selective alpha 1 antagonist that is prescribed in patients with benign prostatic hyperplasia. Phentolamine is a nonselective alpha receptor antagonist that is prescribed in patients with pheochromocytoma.

The nurse is caring for a patient who has been ordered the adrenergic-blocking drug phentolamine. The patient tells the nurse during the admission assessment that his primary health care provider has been including an erectile dysfunction drug as part of his treatment regimen. The nurse anticipates that the interaction of these medications will result in which effect on the patient? Profound hypertension Profound hypotension Increased effect of the phentolamine Increased effect of the erectile dysfunction drug

Profound hypotension

Which medication is used in the treatment of angina? Propofol Pravastatin Propranolol Propoxyphene

Propranolol

The nurse should expect which assessment finding for a patient taking a selective beta 1 receptor blocker? Pulse 62 Wheezing bilaterally Bounding radial pulse Irregular apical pulse

Pulse 62

The nurse is caring for a patient who has been recently diagnosed with hypertension and is to receive an initial dose of atenolol. What is the nurse's primary intervention? Assess the patient's lungs. Call the health care provider. Teach the patient about beta blockers. Ask the patient if he has a history of any respiratory disease.

Teach the patient about beta blockers.

What happens when beta blockers are coadministered with anticholinergics? Reduced beta blocker effect Increased blood glucose levels Enhanced effect of anticholinergics Prolonged neuromuscular blockade

Reduced beta blocker effect

Sotalol is prescribed for a patient experiencing ventricular dysrhythmias. The nurse prepares to administer this medication by doing what? Obtaining a normal saline flush Refilling the patient's water pitcher Selecting a 23-gauge, 1½-inch needle and a 3-mL syringe Choosing a 25-gauge, ¼-inch needle and a 1-mL syringe

Refilling the patient's water pitcher

A patient with pheochromocytoma is prescribed phentolamine. On a follow-up visit, the nurse finds severe hypotension. Which other medication in the patient's medication history would have resulted in this condition? Insulin Digoxin Sildenafil Epinephrine

Sildenafil

The patient has been ordered phentolamine to treat a dopamine extravasation. How is this medication administered? Tablet Topical ointment Subcutaneous injection Intramuscular injection

Subcutaneous injection

The patient is currently taking carvedilol. The patient tells the nurse, "Can you double-check the dosage of my medication for me? The doctor has doubled the dose of my medication, and this must be a mistake." The nurse frames the response to the patient based on which knowledge? The dose of the drug can be increased in increments weekly as tolerated. The dose of the drug should never be changed from the initial starting dose. The dose of the drug can be doubled every 2 weeks to the highest dose tolerated. The dose of the drug can be changed slightly from the starting dose, but very seldom

The dose of the drug can be doubled every 2 weeks to the highest dose tolerated.

Which medication is used in the treatment of hypertension? Tegretol Tapazole Topamax Toprol-XL

Toprol-XL

Which conditions are indications for the use of propranolol? Tremor Migraine Heart failure Hypertension Atrioventricular block

Tremor Migraine Hypertension

A patient diagnosed with benign prostatic hyperplasia (BPH) is on tamsulosin therapy. On the follow-up visit, the nurse finds that the patient has an increased clotting time. Which medication in the patient's medical history does the nurse expect to be the cause of this condition? Insulin Nadolol Warfarin Epinephrine

Warfarin