Pharm Exam 3 EAQ

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Side effects of Selective Beta2 adrenergic agonists

- tachycardia, palpitations, angina - anxiety, tremors - N, V, heartburn, unusual taste. - HA, insomnia, dizzy - repeated high doses → hypokalemia (moves K into the cell)

A client with hypertensive heart disease, who had an acute episode of heart failure, is to be discharged on a regimen of metoprolol and digoxin. What outcome does the nurse anticipate when metoprolol is administered with digoxin? 1Headaches 2Bradycardia 3Hypertension 4Junctional tachycardia

2Bradycardia Metoprolol and digoxin both exert a negative chronotropic effect, resulting in a decreased heart rate. Metoprolol reduces, not produces, headaches. These drugs may cause hypotension, not hypertension. These drugs may depress nodal conduction; therefore, junctional tachycardia would be less likely to occur.

A client being treated for hypertension reports having a persistent hacking cough what class of antihypertensive should the nurse identify as a possible cause of this response when reviewing the list of medications the client takes?

Ace Inhibitors, angiotensin converting enzyme Increases the sensitivity of the cough reflex leading to the common adverse effect sometimes referred to as an ACE Cough.

acute asthma attack treatment

Albuterol per nebulizer

A client who had a myocardial infarction has runs of ventricular tachycardia. Which medication will the nurse prepare to administer? Digoxin Furosemide Amiodarone norepinephrine

Amiodarone

A client has been taking metoprolol (Lopressor) and states to the homecare nurse, "I can't afford this medication any more, and I stopped it yesterday." What is the nurse's primary intervention?

Assess the client's blood pressure. Abrupt withdrawal of a beta-blocking agent can cause rebound hypertension. These drugs should be gradually decreased. The nurse should immediately check the client's blood pressure, and then proceed with teaching and calling the health care provider.

A beta-blocker, atenolol (Tenormin), is prescribed for a client with moderate hypertension. What information should the nurse include when teaching the client about this medication? (Select all that apply.)

Change positions slowly Count the pulse before taking the medication Mild weakness and fatigue are common side effects

Which action describes a therapeutic effect of atenolol?

Decrease HR

What do Alpha 2 agonists do?

Decrease sympathetic impulses from the CNS to the heart and arterioles, causing vasodilation and increase blood flow, so decrease BP. Treat High HTN

An older adult client who has type 1 diabetes and chronic bronchitis is prescribed atenolol for the management of angina pectoris. Which clinical manifestation should alert the nurse to the fact that the client may be developing a life-threatening response to the drug?

Difficulty breathing Atenolol is associated with the adverse reactions of bradycardia, heart failure, and pulmonary edema; these are the most serious responses to atenolol

Which assessment findings would indicate the need for atenolol (selective beta blocker) in a client diagnosed with hyperthyroidism?

In hyperthyroidism, atenolol is prescribed to reduce cardiac manifestations. Tachycardia, atrial fibrillation, and systolic hypertension are cardiac manifestations associated with hyperthyroidism. Distant heart sounds are associated with hypothyroidism. The cardiac output is increased in hyperthyroidism. 1. tachycardia, A-fib, systolic hypertension

For what client response must the nurse monitor to determine the effectiveness of amiodarone (Cordarone)? 1 Results of fasting lipid profile 2 Presence of cardiac dysrhythmias 3 Degree of blood pressure control 4 Incidence of ischemic chest pain

Presence of cardiac dysrhythmias

Aspirin toxicity symptoms

Tinnitus, HA

While administering lidocaine, the nurse will monitor for which adverse drug effect?

Tremors/seizures


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