PHARM 30 PU

Which would the nurse identify as a naturally occurring catecholamine? Metaraminol Dobutamine Ephedrine Dopamine

Dopamine Dopamine is a naturally occurring catecholamine. Dobutamine, ephedrine, and metaraminol are synthetic catecholamines.

A client is receiving dopamine intravenously in the right arm. The IV becomes dislodged from the vein, and dopamine has been being given in the surrounding tissue instead of the vein. What should the nurse do immediately after stopping the IV? Put ice on the infusion site. Wrap the site tightly with gauze. Administer phentolamine to the site. Administer atenolol to the site.

Administer phentolamine to the site. Phentolamine is used to treat/prevent dermal necrosis after IV administration of norepinephrine or dopamine. Placing ice causes vasoconstriction, which could increase the chance of necrosis. Wrapping the site tightly with gauze will not help the tissue absorb the dopamine. Beta blockers will not prevent necrosis at the site of the dopamine infusion.

What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction? Neuromuscular blocking agent Sympathomimetic agents Narcotic antagonist Beta-adrenergic blockers

Beta-adrenergic blockers To counteract the effects of isoproterenol, a beta-specific adrenergic agonist, the nurse would administer a beta-adrenergic blocker.

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? Monitoring of intracranial pressure Respiratory assessment Cardiac monitoring Arterial blood gases

Cardiac monitoring The high potential for adverse effects that is associated with the use of dopamine necessitates vigilant cardiac monitoring. Respiratory assessment, ABGs, and monitoring of ICP are likely indicated by the patient's injuries, but these are not directly related to the use of dopamine.

Which agent would the nurse identify as being available in a transdermal form? Salmeterol Midodrine Phenylephrine Clonidine

Clonidine Clonidine is available in an oral and transdermal form. Midodrine is available in oral form only. Phenylephrine is available in parenteral forms, topical forms, and ophthalmic forms. Salmeterol is available in an inhalation form.

The home health nurse is caring for a 77-year-old male patient who has just been discharged from the hospital. The patient is taking dobutamine for congestive heart failure. What would be most important to monitor in this patient? Availability of caregivers Effectiveness of comfort measures Compliance with drug regimen Dietary intake

Compliance with drug regimen Monitor effectiveness of comfort measures and compliance with regimen. While it would be important to address all options given, it would be most important to monitor the patient's compliance with the drug regimen.

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 Terbutaline Albuterol Phenylephrine

Epinephrine Epinephrine is an alpha- and beta-adrenergic agonist. Phenylephrine is an alpha-specific adrenergic agonist. Albuterol is a beta-specific adrenergic agonist. Terbutaline is a beta-specific adrenergic agonist.

A male client is prescribed an adrenergic ophthalmic medication. What should the nurse include in the teaching plan? The drug is only absorbed locally. Allergic and adverse reactions are rare. Hypertension may be a side effect of the medication. Side effects are limited to inflammation of the conjunctiva.

Hypertension may be a side effect of the medication. Ophthalmic preparations of adrenergic drugs should be used cautiously. For example, phenylephrine is used as a vasoconstrictor and mydriatic. Applying larger-than-recommended doses to the normal eye or usual doses to the traumatized, inflamed, or diseased eye may result in systemic absorption of the drug sufficient to cause increased blood pressure and other adverse effects.

Which is an effect of epinephrine? Decreased blood pressure Peripheral vasodilation Bronchoconstriction Increased heart rate

Increased heart rate Epinephrine increases heart rate and acts as a bronchodilator. It has peripheral vasoconstrictive effects and increases blood pressure.

A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce? Increased vasoconstrictive effects Decreased coronary circulation Increased bronchoconstriction Decreased cerebral circulation

Increased vasoconstrictive effects Epinephrine is added to local anesthetics for vasoconstrictive effects, which include prolonging the action of the local anesthetic drug, preventing systemic absorption, and minimizing bleeding. Epinephrine will not decrease cerebral circulation or coronary circulation. Epinephrine will not increase bronchoconstriction.

What would be most important for the nurse to assess in a client receiving midodrine? Changes in urinary output Changes in respiratory rate Appetite changes Positional blood pressure changes

Positional blood pressure changes Midodrine is associated with a serious supine hypertension. Therefore, monitoring blood pressure changes in different positions (standing, sitting, and supine) would be most important. The drug is not associated with respiratory adverse effects. Decreased urinary output and anorexia may occur, but these would not be as important as monitoring the changes in the client's blood pressure.

A client has been diagnosed with asthma and prescribed albuterol 2 inhalations q6h. When providing client education, what should the nurse teach the client? Administration should be preceded by supplementary oxygen Orthostatic hypotension is possible and the client should transfer carefully following administration Restlessness and anxiety are possible after administration The client must be in a high Fowler's position in order to inhale the medication

Restlessness and anxiety are possible after administration Sympathetic stimulation associated with albuterol can cause anxiety, restlessness and increased blood pressure. There is no absolute need to precede its use with oxygen. Upright positioning is beneficial but not absolutely necessary.

Prior to beginning therapy with an adrenergic agent, the nurse would expect to obtain what assessments? (Select all that apply.) Arterial blood gases Urinalysis Blood glucose Vital signs Hearing screen

Vital signs Urinalysis Blood glucose The nurse obtains the client's weight and assesses skin color, temperature, and turgor. Orientation status, reflexes, pulse, blood pressure, respiratory rate, and auscultation of lung sounds are also important to obtain. Required laboratory data include urinalysis, renal function, blood and urine glucose, serum electrolytes, and thyroid function. In addition, an electrocardiogram may be necessary. A hearing screen and arterial blood gases would not be needed.

A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action? monitor respiratory rate. measure urine output. assess heart rate. check blood glucose level.

assess heart rate. The client's heart rate must be assessed prior to administration of alpha- and beta-adrenergic agonists. There would be no need to check blood glucose or measure urinary output, and though respiratory rate is monitored it is not the priority measure.

In providing care to a client with wheezing, the nurse knows that a medication targets which receptors? alpha 1 beta 1 beta 2 alpha 2

beta 2 Beta 2 receptors are found on the bronchial smooth muscles, and medications that stimulate beta 2 receptors cause bronchodilation. Alpha 1 receptors cause vasoconstriction of peripheral blood vessels. Alpha 2 receptors decrease tone, motility, and secretions of the GI tract. Beta 1 receptors increase heart rate and force of myocardial contraction.

Epinephrine causes relaxation of: bronchioles. smooth muscles in the intestinal wall. superficial blood vessels. sphincter muscles.

bronchioles. Epinephrine is the adrenergic drug of choice for relieving the acute bronchospasm and laryngeal edema of anaphylactic 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 body temperature. increase blood pressure. decrease blood pressure. decrease heart rate.

increase blood pressure. For a client in shock, dopamine helps to increase blood pressure. The alpha stimulation produces increased peripheral resistance, raising the blood pressure as the dose of dopamine increases. The drug's dosage is titrated upward until adequate perfusion of vital organs is achieved. Beta-1 stimulation produces increased cardiac output by increasing the force of contraction and heart rate. The drug does not have a direct effect on body temperature.

The intravenous line of a client receiving dobutamine infiltrates and the drug extravasates. The nurse would infiltrate the site with: hyaluronidase. phentolamine. sodium bicarbonate. lactated Ringer's solution.

phentolamine. If extravasation occurs, the nurse should infiltrate the site with 10 mL of saline containing 5 to 10 mg of phentolamine. Hyaluronidase and sodium bicarbonate may be used for extravasation of certain antineoplastic agents. Lactated Ringer's solution would be inappropriate.

A client is taking an OTC allergy product. The nurse would expect to find that this product most likely contains: phenylephrine. ephedra. albuterol. epinephrine.

phenylephrine Phenylephrine is a common agent found in many OTC cold and allergy products. Ephedra has been banned by the Food and Drug Administration as a drug. Neither epinephrine nor albuterol are found in OTC products.

Adrenergic drugs mimic the effects of stimulating what part of the nervous system? sympathetic parasympathetic central autonomic

sympathetic An adrenergic drug is an agent that produces effects like those produced by stimulation of the sympathetic nervous system and therefore has widespread effects on body tissues. These drugs do not mimic the effect of the parasympathetic nervous system. The autonomic nervous system comprises the sympathetic and parasympathetic systems.

Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction? β1 receptors β2 receptors α2 receptors α1 receptors

β1 receptors β1 receptors are responsible for increased heart rate and increased force of myocardial contraction. Vasoconstriction of peripheral blood vessels occurs as the result of stimulation of α1 receptors. Stimulation of α2 receptors inhibits release of norepinephrine into synapses of sympathetic nervous system. Stimulation of β2 receptors leads to vasodilation of the peripheral vessels and also causes bronchodilation.

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? Observe the client closely for seizures, hypothermia, and dementia; if seen, stop the infusion immediately. Leave the room so that the client can sleep and not risk sleep deprivation psychosis. Prepare the family by telling them how sick their loved one is and that he may die. Continually assess the client for physiological changes and notify the primary care provider with changes.

Continually assess the client for physiological changes and notify the primary care provider with changes. When caring for a client receiving an adrenergic medication for shock, the nurse will continually assess the client for changes in his vital signs, perfusion, and any adverse reactions. Telling a family that their loved one might die is not an appropriate nursing action at that time. Seizures, hypothermia, and dementia are not common side effects of adrenergic medications, and an adrenergic medication should not be abruptly stopped. The nurse needs to stay close to a client to do frequent assessments; sleep deprivation may occur, but it is not the primary concern when a client is in shock.

A client is experiencing anaphylaxis. What drug will the nurse most likely administer? Dantrolene sodium Epinephrine Norepinephrine Acetylcysteine

Epinephrine Epinephrine is the adrenergic drug of choice for relief of anaphylactic shock, the most serious allergic reaction, as well as in treatment of cardiac arrest. Norepinephrine used to treat severe hypotension and shock that persists after adequate fluid volume replacement. Acetylcysteine is used for acetaminophen overdose. Dantrolene sodium is used to treat malignant hyperthermia.

Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly. True False

True Patients who are receiving alpha-specific adrenergic agents should not discontinue the drug abruptly because sudden withdrawal can result in rebound hypertension, arrhythmias, flushing, and even hypertensive encephalopathy and death; taper the drug over 2 to 4 days.

Phentolamine is the agent used to treat extravasation of dobutamine. True False

True Maintain phentolamine on standby in case extravasation occurs.

Which receptor does phenylephrine stimulate? Alpha1 Beta2 Alpha2 Beta1

Alpha1 Phenylephrine stimulates alpha1 receptors.