Pharmacology Prep U Chapter 29: Introduction to the Autonomic Nervous System

The adrenergic receptors are categorized as alpha or beta. Which action results from stimulation of alpha2 receptors?

Inhibited release of norepinephrine

The body uses tyrosine in the diet to make what substance?

Norepinephrine

A client with chronic obstructive pulmonary disease (COPD) is experiencing bronchoconstriction. When choosing interventions to address this problem, the nurse should aim to influence the client's autonomic nervous system by stimulating:

beta-adrenergic receptors.

Nicotinic receptors would be found in which location?

Adrenal medulla

A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention?

Aldosterone

The nurse is assessing a client who has urinary hesitation and occasional overflow incontinence. What adrenergic receptors may be overstimulated in this client?

Alpha-1

Which receptor is found in the beta cells of the pancreas?

Alpha-2

Norepinephrine is made by nerve cells using which substance?

Tyrosine

Deactivation of norepinephrine (NE) occurs by breakdown of NE by which enzyme?

COMT

A client admitted to a cardiac unit asks why a rest period is required each afternoon. The nurse's response should be based on what information regarding the PNS?

"Clients are encouraged to rest and relax during this time, free of families and visitors."

Which would be included when describing the parasympathetic nervous system structure and function?

* Ganglia are located close to or within the effector tissue. * Muscarinic and nicotinic receptors are found in the parasympathetic nervous system.

After the nurse administers an adrenergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body? Select all that apply.

* Provide sunglasses to wear. * Increase fluid intake.

The nurse would predict which assessment findings after administering a parasympathomimetic medication to the client? Select all that apply.

* Pupils are constricted bilaterally. * Client states, "I am able to empty my bladder easier." * Pulse before med: 90 and after med: 70.

Nicotinic receptors are found in which area?

Autonomic basal ganglia

Which type of cells synthesize and store norepinephrine and epinephrine?

Chromaffin

The nurse is conducting an assessment of a newly admitted client. What assessment finding should suggest to the nurse that the client's muscarinic cholinergic receptors are being stimulated?

The client has "pinpoint" pupils.

The functions of the autonomic nervous system (ANS) can be broadly described as:

activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues.

Which receptor is responsible for increasing blood pressure?

alpha1 receptors

Which effect results from activation of beta2 receptors?

bronchodilation

The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by:

stimulating beta2-receptors.

A client has begun to experience post-operative pain and the client's heart rate has increased from 72 beats per minute to 96 beats per minute. The nurse should attribute this change to the effect of:

stimulation of beta1 receptors in the sympathetic nervous system.

Sympathetic stimulation of the heart causes:

an increased rate and force of myocardial contraction.

Which statements are correct regarding adrenergic receptors? Select all that apply.

* Epinephrine acts on beta receptors. * Epinephrine acts on alpha receptors.

In the sympathetic nervous system, which is the origin of central nervous system nerves?

thoracic spinal cord

The sympathetic and the parasympathetic nervous systems are continuously at work in our bodies. This continual action provides a sense of balance to all parts of the body. What is the term used to represent this sense of balance?

Homeostasis

A client has had a stroke and computed tomography reveals infarcts in multiple brain regions. An infarct in which region is most likely to affect the function of the client's autonomic nervous system?

Hypothalamus

A patient is suffering from a heart rate of 42 beats per minute. Which system contributes to bradycardia?

parasympathetic nervous system

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction?

sympathetic nervous system

A patient has received the evening meal and is recovering from surgery. What nervous system is stimulated?

parasympathetic nervous system

After the nurse administers a cholinergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body? Select all that apply.

* Auscultate lung sounds and report bronchoconstriction. * Instruct client to report diarrhea. * Compare muscle strength to baseline for improvement.

A preoperative client admits to feeling intensely anxious about surgery and the nurse recognizes that the client's sympathetic nervous system is stimulated. What assessment findings should the nurse attribute to this stimulation? Select all that apply.

* Dilated pupils * Increased blood pressure * Increased respiratory rate * Increased sweating

Which statements are correct regarding the autonomic nervous system (ANS) receptors? Select all that apply.

* Drug effects depend on the branch of the ANS involved. * Medications can either stimulate or inhibit the ANS.

A client is experiencing anxiety and consequent stimulation of the sympathetic nervous system. The nurse is aware that norepinephrine is being released into synapses. Overstimulation by this neurotransmitter will be prevented by what physiological processes? (Select all that apply.)

* Reuptake into the presynaptic neuron * Deactivation by monoamine oxidase * Deactivation by catechol-O-methyl transferase (COMT)

The main nerve centers for the autonomic nervous system (ANS) are located in which locations? (Select all that apply.)

* Spinal cord * Medulla * Hypothalamus

The nurse administers intravenous (IV) norepinephrine to the client diagnosed with shock. The nurse would predict which receptor subtypes to be activated resulting in a stimulatory response? Select all that apply.

* alpha1 * alpha2 * beta1

Which body functions are controlled by the autonomic nervous system (ANS)? Select all that apply.

* blood pressure * digestion * heart rate * metabolism

A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency?

Autonomic nervous system

A patient is using his incentive spirometer during the postoperative period. The skeletal muscles during the use of the incentive spirometer are stimulated by which neurotransmitter?

Acetylcholine

The nurse is caring for a client who is under psychological and physiological stress. During sympathetic stimulation, the nurse should identify which neurotransmitter as being released by the preganglionic nerves of the sympathetic nervous system?

Acetylcholine

What does the body create using choline?

Acetylcholine

A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors?

Beta-2

Stimulation of the sympathetic nervous system results in all of the following EXCEPT:

Decreased rate of cellular metabolism.

Which is NOT a function of the body's homeostatic control systems?

Feed cells under stress

The nurse is providing care for a client whose health history includes type 1 diabetes, peripheral vascular disease, environmental allergies and rheumatoid arthritis. The client is transitioning from living independently to living in a long-term care facility, which is causing the client intense stress. This stimulation of the client's sympathetic nervous system should prompt the nurse to prioritize what assessment?

Frequent blood glucose monitoring

Most of the free norepinephrine molecules are taken up by the nerve terminal that releases them in which process?

Reuptake

A client's pain is causing stimulation of the sympathetic nervous system, including alpha1-receptors. What assessment finding should the nurse ascribe to the stimulation of these receptors?

The client's pupils are dilated to 8 mm

The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function?

The client's respiratory rate is 22 breaths per minute

When describing the sympathetic nervous system, the instructor would include:

The relatively long postganglionic fibers synapse with neuroeffectors.

The nursing instructor is explaining the role of the parasympathetic nervous system in influencing body functions. Which change in a patient's body functions would be directly related to the stimulation of the parasympathetic nervous system?

decreased heart rate

The nurse prepares to administer a preoperative anticholinergic to a client. What is a desired effect based upon the characteristics of the prescribed medication?

dry mucous membranes