NUR 2144 Pharmacology II Chapter 30: Adrenergic Agonists

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 receptor does phenylephrine stimulate?

Alpha1

Which condition is treated with an adrenergic agonist?

Anaphylaxis

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

False

An increased dosage of digoxin would be needed if the patient is also taking midodrine.

False

A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient?

Cardiac arrhythmias

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

A patient is receiving salmeterol. The nurse would expect this drug to be given by which route?

Inhalation

A client who is in shock has been prescribed a dopamine intravenous infusion. What component of the client's existing medication regimen most increases the client's risk for adverse effects?

Phenelzine

What would be most important for the nurse to assess in a client receiving midodrine?

Positional blood pressure changes

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

Sympathetic nervous system

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

Sympathomimetics

A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary health care provider?

Systolic blood pressure below 100 mm Hg

A client is receiving phenylephrine via intramuscular injection. The nurse would expect the drug to begin acting in approximately which amount of time?

10 to 15 minutes

A patient receives phenylephrine intravenously. The nurse would expect the drug to last for how long?

15 to 20 minutes

The nurse is teaching a client about safe use of adrenergic drugs. Which statement should be included in the teaching?

"Talk to your health care provider before taking any other medications."

A client is being treated in the intensive care unit for cardiogenic shock. The client has been prescribed an intravenous infusion of dopamine 5 mcg/kg/minute. The client weighs 220 lbs and the medication is available in a 500-ml bag containing 400 mg of dopamine. At what rate in mL/hour should the nurse administer the medication? Give your answer to one decimal place.

37.5

Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A 47-year-old female with hypertension

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 patient has been prescribed dopamine. Which intervention should the nurse perform during the drug regimen?

Administer dopamine only via IV route.

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?

Administer phentolamine to the site.

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

Bronchodilation

A client is being treated for asthma. What would the nurse expect to administer?

Beta-2-specific adrenergic agonist

What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction?

Beta-adrenergic blockers

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?

Cardiac monitoring

A nurse is caring for an elderly patient who is to be administered isoproterenol. Which change monitored in the patient should the nurse report immediately to the primary health care provider?

Changes in pulse rate

Which agent would the nurse identify as being available in a transdermal form?

Clonidine

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?

Compliance with drug regimen

A nurse suspects that a client is experiencing shock based on which assessments? Select all that apply.

Cyanosis Tachypnea Disorientation

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

A nurse is caring for a patient who is on a drug regimen of midodrine to treat hypotension. What would be an appropriate nursing diagnosis to include in the care plan of this patient?

Disturbed sensory perception (visual, kinesthetic, tactile) related to CNS effects

The nurse is assessing a client in the emergency department who has taken an overdose of phenylephrine. What symptoms should the nurse be alert for in this client? (Select all that apply.)

Dizziness Headache Seizures

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

Ephedra

A patient suffers from bronchial asthma. Which medication is a mixed-acting adrenergic drug?

Ephedrine

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

Epinephrine

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

Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm?

Epinephrine

A nurse would instruct a patient to apply a clonidine patch at which frequency?

Every 7 days

The nurse is reviewing the history of a patient who is to receive midodrine. Which would alert the nurse to a contraindication for the drug?

Glaucoma

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 male client is prescribed an adrenergic ophthalmic medication. What should the nurse include in the teaching plan?

Hypertension may be a side effect of the medication.

Which assessment finding would indicate to the nurse that the administered isoproterenol is effective?

Improved cardiac contractility

The nurse would contact the health care provider before administering an adrenergic drug to a client who is also taking which drug?

MAO inhibitor

A home care nurse is visiting a patient to assess blood pressure and heart rate. The patient's grandson has a large amount of pseudoephedrine (Sudafed) in the kitchen. For what might the nurse suspect the patient's grandson is using the pseudoephedrine?

Methamphetamine production

Epinephrine is contraindicated in clients with which diseases or disorders?

Narrow-angle (or closed-angle) glaucoma

A need for additional education on the administration of epinephrine is needed when a new nursing graduate indicates that epinephrine can be effectively administered by what route?

Oral

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

Epinephrine can be administered by multiple routes. Which is not an appropriate route?

Oral

The nurse is reviewing the history of a client receiving isoproterenol. Which would the nurse identify as being a contraindication?

Pulmonary hypertension

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 nurse is reviewing the medical record of a client who is taking an alpha- and beta adrenergic agonist. What would be of least concern to the nurse?

St. John's wort

The nurse is aware that epinephrine may be administered in what ways? (Select all that apply.)

Topical Inhalation IV

Phentolamine is the agent used to treat extravasation of dobutamine.

True

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.

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

beta 2

Epinephrine causes relaxation of:

bronchioles.

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.

The intravenous line of a client receiving dobutamine infiltrates and the drug extravasates. The nurse would infiltrate the site with:

phentolamine.

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

phenylephrine.

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

sympathetic

Which of the following adrenergic receptors is responsible for the vasoconstriction of peripheral blood vessels?

α1 receptors

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

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

Increased vasoconstrictive effects

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.

The nurse is assessing a client who received epinephrine, an adrenergic drug, for the treatment of cardiac arrest. The nurse would expect to observe what effect of the drug?

Increased heart rate

Which is an effect of epinephrine?

Increased heart rate

The nurse knows that what is an added benefit of epinephrine in cardiac arrest situations due to asystole or pulseless electrical activity?

Stimulates electrical and mechanical activity