Adult Health Theory II

What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago?

beta-blockers

A nurse is caring for a client in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the client's chart for indications of:

history of acute myocardial infarction.

A patient with diabetes who uses insulin is also receiving labetalol. The nurse would monitor the patient closely for:

hypoglycemia.

Which observation might indicate that timolol is achieving the desired effect in a client?

intraocular pressure decreases

The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications?

sympathetic

A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to:

understand the signs and symptoms of hypoglycemia.

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings?

Heart rate and blood pressure

Which patient statement indicates the need for additional teaching about propranolol?

I can stop the drug once my blood pressure is controlled."

A client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in the chest. While obtaining the clients history, the nurse learns the client stopped taking medications because the prescriptions ran out and had no funds to refill them. The nurse knows that which medications being abruptly stopped could be causing these symptoms?

Labetalol

A client has been prescribed labetalol IV for a pheochromocytoma. What is the expected effect of the medication?

Management of the resulting hypertension

A provider orders timolol (Timoptic) for glaucoma. The order reads Timoptic 1 gtt PO bid. The nurse knows that something is wrong with this order. What is it?

Timoptic is given in the eye, not PO.

A nursing instructor determines that a class on adrenergic blockers was successful when the students identify which medications as an alpha-adrenergic blocker?

Phentolamine

Which non-selective alpha-adrenergic blocking agent is still used?

Phentolamine

A client has received a dose of dopamine intravenously. The client's IV was infiltrated, and the dopamine was injected into the subcutaneous tissues. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?

Phentolamine mesylate (Regitine)

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders?

All the above

A patient is receiving sotalol. Which instruction would be most important for the nurse to provide to the patient to ensure maximum effectiveness of the drug?

"Be sure to take the drug on an empty stomach."

The male client is prescribed prazosin (Minipress) for hypertension. He asks the nurse how the medication works. What is the nurse's best response?

"It works by making your blood vessels dilate."

A client is prescribed propranolol for a diagnosis of essential tremors. What request made by the nurse while assessing the client demonstrates an understanding of the proper evaluation of this medication therapy?

"Please pick up that glass and bring it to your mouth."

A client is hospitalized for heart failure and is being treated with a beta blocker. What client teaching should the nurse include about side effects? Select all that apply.

"You may feel light-headed and dizzy when you stand up, so ask for assistance prior to getting out of bed." "Your heart rate will decrease so, your blood pressure could become low, too. Notify the nurse if you feel like you are lightheaded."

A nurse is reviewing a client's history and medications prior to discharge. The client has been prescribed a new antiadrenergic medication. Which condition or medication would require the nurse to talk with the provider prior to discharge? Select all that apply.

Active hepatitis B Treatment for depression with an MAOI Pregnancy Renal impairment

First-dose effect occurs when the client experiences marked hypotension and syncope with sudden loss of consciousness with the first few doses of the sympatholytic. Which intervention might be helpful for the nurse to do to decrease the risk for first-dose effect?

Administer the dose at bedtime

When administering sotalol to a client, which would be most appropriate?

Administer the drug before meals.

A client is experiencing urinary retention. The client has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention?

Benign prostatic hypertrophy

The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes?

Beta-adrenergic blocking drugs

A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do?

Call the provider and advise them of the client's blood pressure prior to administering the medication.

A client has come to get lab results at the cardiology clinic. The nurse notes that the digoxin level is elevated. The nurse knows that what other medication may be responsible for the increase in digoxin level?

Carvedilol

A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart?

Decrease the heart rate

A client has been prescribed an adrenergic blocking drug for glaucoma. Which nursing interventions should the nurse include when teaching the client?

Demonstrate the technique of eye drop instillation

The nurse is preparing a teaching plan for a patient who is to receive a nonselective beta blocker. The nurse would make sure to address safety measures as a priority for the patient receiving:

Propranolol

Beta-1 selective blockers have what as an effect?

Reduction in arrhythmia

A client has been prescribed the nonselective beta-adrenergic blocker, timolol for the treatment of open angle glaucoma. What instructions should the nurse provide to assure the effectiveness of the medication?

The proper method for instilling eye drops