Chapter 29
Assess blood pressure. Count respirations. Evaluate pupils.
The nurse is caring for a client who is experiencing pain. The client describes the pain as "9" on a scale of 1 to 10, with 10 being the worst pain. What nursing interventions would be necessary for the nurse to implement? Select all that apply.
stimulating beta2-receptors.
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:
Stimulation of beta-adrenergic receptors
The nurse is caring for a client with asthma who has been experiencing shortness of breath and who has been administered a medication to cause bronchodilation. What aspect of autonomic nervous function has the nurse most likely influenced?
activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues.
The functions of the autonomic nervous system (ANS) can be broadly described as:
Acetylcholine
What does the body create using choline?
Decreased bowel sounds
When there is stimulation of the SNS, blood is diverted away from the GI tract. What indicates this diversion?
Tachycardia Pupil dilation Diaphoresis
When working with a client who is experiencing a stress response, the nurse should anticipate what effects? Select all that apply.
Bronchodilation
Which effect results from activation of beta2 receptors?
It allows the autonomic system to maintain a fine control over internal homeostasis. It is sometimes called the craniosacral system.
Which is consistent with the parasympathetic nervous system? (Select all that apply.)
Acetylcholine
Which neurotransmitter is involved in pre- and postganglionic activity in the parasympathetic nervous system?
Hypothalamus
Which structure is responsible for the secretion of adrenocorticotropin hormone?
"Clients are encouraged to rest and relax during this time, free of families and visitors."
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?
The client's blood pressure is decreased
A client has been prescribed a medication that antagonizes the beta receptors of the sympathetic nervous system. What assessment finding should the nurse attribute to the effects of this medication?
Hypothalamus
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?
Muscle contraction
Cholinergic receptors are classified as nicotinic or muscarinic. What is a result of the stimulation of the nicotinic receptors?
Reuptake
Most of the free norepinephrine molecules are taken up by the nerve terminal that releases them in which process?
Adrenergic
Nerve fibers secreting norepinephrine are called:
Autonomic basal ganglia
Nicotinic receptors are found in which area?
an increased rate and force of myocardial contraction.
Sympathetic stimulation of the heart causes:
decrease dopamine release increase smooth muscle contraction increase glandular secretion
The muscarinic1 and muscarinic3 receptors of the parasympathetic nervous system (PNS) are similar in function. Which functions do these two receptors have in common? Select all that apply.
Acetylcholine
The nervous system is closely linked with both the immune system and the endocrine system. What neurotransmitter is used by the preganglionic cells?
Alpha1 Alpha2 Beta1
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.
Stimulation of beta-receptors
The nurse assessed a client at 0800 and obtained a blood pressure of 111/70 mmHg. Two hours later, the client's blood pressure is 130/81 mmHg. The nurse should attribute this change to what action within the autonomic nervous system?
The client's respiratory rate is 22 breaths per minute
The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function?
Vasodilation of blood vessels
The physiology instructor explains to the nursing students that beta-2 stimulation leads to:
Piloerection
What helps to generate heat when the core body temperature is too low?
Increased GI motility
What is the resulting physiologic effect when the parasympathetic nervous system is stimulated?
stimulation of beta1 receptors in the sympathetic nervous system.
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:
Beta-1
A client in distress has been given dobutamine, a medication intended to increase myocardial activity and heart rate. This medication likely stimulates what adrenergic receptor?
Aldosterone
A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention?
Beta-2
A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors?
Adrenal medulla
Nicotinic receptors would be found in which location?
Tyrosine
Norepinephrine is made by nerve cells using which substance?
Alpha1
The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the blood vessels, iris, and urinary bladder?
Beta1
The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate?
Norepinephrine
The body uses tyrosine in the diet to make what substance?
BP 100/60 Glucose 150 mg/dL (8.32 mmol/L) RR 20
The nurse is caring for a client with premedication data as follows: blood pressure (BP) 88/40 mm Hg, heart rate (HR) 45, respiratory rate (RR) 12, glucose 70 mg/dL, cardiac output (CO) 3.8 L/min (normal range 4-6 L/min). The nurse would predict which assessment findings after administering a sympathomimetic to the client? Select all that apply.
The client has "pinpoint" pupils.
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?
Recommend that the client wear sunglasses. Instruct the client to increase fluid intake.
The nurse is preparing to administer an adrenergic medication to a client. What instructions will the nurse include in client teaching related to the drug's actions on the body? Select all that apply.
Paralysis
A surgical client has been administered a medication that blocks nicotinic acetylcholine receptor sites and which does not cross the blood-brain barrier. The nurse should assess for what expected finding after administration?
an increase in blood pressure, bronchi dilation, and decreased bowel sounds
A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves:
Decreased heart rate
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?
Classification based on research with a mushroom plant alkaloid
The nursing students are giving an oral presentation on the parasympathetic nervous system. How would they describe muscarinic receptors?
beta-adrenergic receptors.
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:
Increased norepinephrine levels in the sympathetic nervous system
A client's atypical depression is being treated with a monoamine oxidase inhibitor. The nurse should identify what effect on the function of the autonomic nervous system?
Sympathetic 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?
Autonomic nervous system
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?
Parasympathetic nervous system
A patient is experiencing a heart rate of 42 beats per minute. Which system contributes to bradycardia?
Homeostasis
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?
