chapter 23

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

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

Sympathomimetics

A nurse is providing teaching to a client prescribed midodrine. Which nursing instruction is very important that the client understands?

"Only take midodrine when standing. Taking it while lying down can cause very high blood pressure."

Which condition is treated with an adrenergic agonist?

Anaphylaxis

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.

An older adult has been prescribed midodrine. What is the most important nursing action to include in the plan of care for this client?

Assess positional blood pressures.

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

Bronchodilation

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

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.

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

Alpha- and beta-specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions.

False

The adrenergic branch of the nervous system controls many functions in the body. The nurse knows that which body functions are controlled by the adrenergic branch? (Select all that apply.)

Heart rate Respiratory Rate Muscle blood flow

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

The client is given epinephrine for an exacerbation of asthma. What response to the medication would the nurse expect?

Increased ease of breathing and increased heart rate

Which is an effect of epinephrine?

Increased heart rate

Which is expected after the administration of an adrenergic medication such as epinephrine? (Select all that apply.)

Increased heart rate Vasoconstriction

An adrenergic drug being infused in a client's peripheral intravenous site infiltrates. Which action would be the priority for the nurse?

Inject the site with phentolamine in saline.

When administering an adrenergic drug, a nurse understands that which is the primary neurotransmitter of the sympathetic nervous system?

Norepinephrine

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

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.

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

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

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

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.

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

The nurse provides a client with a dose of the beta-selective adrenergic agonist isoproterenol. Which assessment finding indicates the medication is effective?

increased heart rate

The nurse is preparing to administer a sympathomimetic drug to a client. How does this drug achieve a therapeutic effect?

stimulating alpha- and beta-receptors

Adrenergic drugs mimic the effects of stimulating what part of the nervous system?

sympathetic

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

The nurse is administering epinephrine IV push. The nurse checks for patency of the IV prior to administration of the drug. The nurse realizes that if the IV is infiltrated, the medication will result in tissue extravasation. What is the reason for such an occurrence?

The medication causes vasoconstriction, limiting the blood flow to the area.

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

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 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 blood pressure.