prep u for chp 23 pharm

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The client has been prescribed norepinephrine. While the nurse is teaching the client about this medication, the client asks the nurse what is it for. What is the nurse's best response?

"It is a neurotransmitter that keeps the nerve message going from the brain to the organ."

Which client is most likely to benefit from the administration of an adrenergic agonist?

A man who is in cardiogenic shock following a myocardial infarction

A nurse is caring for a client admitted to the emergency department with symptoms of increased heart rate, dilated pupils, and rapid breathing. The client suddenly goes into cardiogenic shock while reporting these symptoms to the health care provider. Which action should the nurse prioritize?

Administer an adrenergic drug to improve hemodynamic status.

A client goes to his primary care provider for a cut finger. The provider is going to put sutures into the tip of the client's finger. Lidocaine with 2% epinephrine is ordered verbally by the provider. What should the nurse do?

Ask if he really wants epinephrine in the lidocaine since he is working on the tip of the finger. The nurse remembers from her reading that epinephrine is contraindicated in fingertips.

A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective?

Bronchodilation

A client suffering an acute myocardial infarction may develop which type of shock?

Cardiogenic-obstructive shock

A nurse is caring for a 25-year-old client who has been prescribed an adrenergic drug for shock. Which action should the nurse implement?

Continually assess the client for physiological changes and notify the primary care provider with changes.

Adrenergic medications such as epinephrine and dopamine are commonly used for in the treatment of clients in which treatment settings? Select all that apply.

Dentist's office Intensive care unit Emergency department

Which herbs has been removed from most weight-loss medications due to potential legal liability?

Ephedra

A client is experiencing anaphylaxis. What drug will the nurse most likely administer?

Epinephrine

A nurse is caring for a client in the intensive care unit who has been administered dopamine to manage hypotension and improve cardiac output. The nurse observes that the client's blood pressure has significantly increased beyond the target range. Which action should the nurse prioritize in this situation?

Immediately stop the dopamine infusion and notify the health care provider.

A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?

Increased vasoconstrictive effects

The nurse notes that a client is prescribed midodrine. Which action should the nurse take before giving the client this medication?

Measure orthostatic blood pressure.

An older adult client who is experiencing hypovolemic shock is prescribed intravenous (IV) dopamine. Which action would the nurse take while monitoring the client while receiving this medication?

Monitor the client's cardiac rhythm.

Epinephrine is contraindicated in clients with which diseases or disorders?

Narrow-angle (or closed-angle) glaucoma

Why are older adults more likely than other clients to have adverse reactions when taking adrenergic drugs?

Older adults often have other illnesses that may be aggravated by adrenergic drugs.

A client was brought by ambulance into the emergency department. The client appears disoriented, pale, tachycardic, and hypotensive. There is excessive bleeding from the head and bruises across the cheek and abdomen. What is the priority step in managing this client?

Provide basic life support while attempting to treat hypovolemic shock.

A nursing student is to write a care plan with priority nursing diagnosis for the client who is severely allergic to bees. Which nursing diagnoses would be correct?

Risk for Allergic Response

A 27-year-old client has been in the intensive care unit for two weeks following a car accident. The primary nurse is concerned that the client is not getting the rest needed for recovery. Which nursing diagnosis would be appropriate for this problem?

Risk for Disturbed Sleep Pattern related to hospitalization

The adrenergic branch of the autonomic nervous system is also known by which name?

Sympathetic nervous system

When describing the adrenergic branch of the autonomic nervous system to a group of nursing students, the instructor would also refer to it as which type of nervous system?

Sympathetic nervous system

Drugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following?

Sympathomimetics

The nurse is caring for a client receiving an adrenergic agent. Which approach would the nurse expect when the client's status improves and the medication is to be discontinued?

Titrate reduced doses over 2-4 days.

A client is in shock and is receiving dopamine. The nurse knows that the proper way dopamine should be given is by what method?

Via an electric infusion pump, by itself, and titrated to desired systolic blood pressure

In providing care to a client with wheezing, the nurse knows that a medication targets which receptors?

beta 2

A client is admitted to the emergency department with signs and symptoms of cardiogenic shock. Isoproterenol is administered intravenously. What assessment should the nurse prioritize when monitoring for therapeutic effects?

blood pressure

Epinephrine causes relaxation of:

bronchioles.

An 80-year-old client has been brought to the emergency department in shock. The client is receiving dopamine. The nurse should prioritize the assessment for what potentially serious adverse effect?

cardiac arrhythmia

Mrs. Kelly Johnson, aged 46, was admitted to the hospital due to prior myocardial infarction, or heart attack. The diagnostic test revealed that her heart was unable to pump enough blood to adequately perfuse the vital organs. What type of shock does she seem to have suffered from?

cardiogenic shock

The nurse is caring for a client who is receiving an intravenous infusion of dobutamine. What nursing diagnosis has most likely prompted this intervention?

decreased cardiac output

A client being treated with intravenous (IV) fluids for hypovolemic shock is prescribed an adrenergic medication. For which reason should the nurse closely monitor the effects of this medication on the client?

diagnosed with peripheral vascular disease

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?

epinephrine

The nurse is admitting a client with injuries following a bicycle crash. When reviewing the client's pre-admission medication regimen, the nurse reads that the client takes formoterol twice daily. When planning this client's care, the nurse should include:

frequent respiratory assessments.

A client with significant burns develops shock and requires adrenergic drug therapy. The nurse interprets this as which type of shock?

hypovolemic

A group of nursing students are reviewing information about the types of shock. The students demonstrate understanding of the information when they identify which occurs as a result of gastrointestinal bleed?

hypovolemic shock

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:

increase in blood pressure

The stimulation of beta1 adrenergic receptors in the heart by epinephrine would cause what result?

increased heart rate

Which is an effect of epinephrine?

increased heart rate

The stimulation of beta1 adrenergic receptors in the heart by epinephrine would cause what result?

increased heart rates

After reviewing the routes of administration for beta-specific adrenergic agonists, a group of students demonstrate the need for additional study when they identify isoproterenol as being administered by which route?

oral

The nurse is reviewing information collected from the parent of a pediatric client who uses the adrenergic drug albuterol inhaler as prescribed for asthma. Which information would the nurse suspect caused the client to have the extreme reaction to the adrenergic drug?

received an over-the-counter (OTC) cold remedy

A client is prescribed a medication that will directly stimulate the adrenergic receptor sites. Which finding(s) will the nurse expect that indicates the medication has been effective? Select all that apply.

sweating dilated pipils increased heart rates increased resoirations

A nurse is attending to a client who has been administered norepinephrine. The nurse would be alert for the development of which adverse reactions? Select all that apply.

tachycardia lightheadedness nausea

The nurse is transcribing new orders for sympathomimetic medications prescribed for a geriatric client. What should the nurse expect the dosage to be?

the lowest possible effective dosage

Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction?

β1 receptors

Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation?

β2 receptors

What client would be most likely to benefit from the administration of a beta2-specific adrenergic agonist?

a client who is having an exacerbation of chronic bronchitis

A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the clients symptoms?

acute bronchospasm

Which condition is treated with an adrenergic agonist?

anaphylaxis

A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action?

assess heart rate.


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