Ch. 27: Adrenergic Drugs

A client is seen in the emergency department for third-degree burns over 50% of his body. The nurse knows that this client is experiencing what type of shock due to fluid loss?

Hypovolemic shock

Which condition is treated with an adrenergic agonist?

Anaphylaxis

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

"Talk to your doctor before taking any other medications."

With certain health conditions, adrenergic drugs should NOT be used. Which of the following are examples? Choose all that apply.

-Atrial fibrilation -Myocardial ischemia -Hypertensive crisis -Cerebrovascular accident

Phenylephrine (e.g., Neo-Synephrine, others) is a synthetic drug that acts on alpha-adrenergic receptors to produce vasoconstriction. Which of the following are actions of this drug? Choose all that apply.

-Decreases cardiac output and renal perfusion -Increases peripheral vascular resistance and blood pressure

When caring for a patient receiving adrenergic drugs, the nurse would establish with him or her which of the following goals? Choose all that are appropriate.

-Receive or self-administer drugs accurately. -Demonstrate knowledge of adverse drug effects. -Comply with instructions for safe drug use.

A 4-year-old is admitted to the Emergency Department in shock after a motor vehicle accident. The patient is found to be 12.5 kilograms. What would be the minimum safe dose of adrenalin if the pediatric dose is 0.005-0.01 mg/kg IV?

0.0625 mg

The nurse is preparing discharge teaching for four patients. Which patient should be advised by the nurse that OTC cold and allergy preparations contain phenylephrine and should be avoided?

A 47-year-old female with hypertension

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

The nurse is giving isoproterenol parenterally. Before starting to administer the drug, what would the nurse be sure to have on hand in case a severe reaction occurs?

A beta-adrenergic blocker

Which patient is most likely to benefit from the administration of an adrenergic agonist?

A man who is in cardiogenic shock following a myocardial infarction

Clinical indications for the use of adrenergic drugs stem mainly from their effects on the heart, blood vessels, and bronchi. They are often used as emergency drugs. For which of the following conditions would these drugs be used? Choose all that apply.

Acute cardiovascular disorders Allergic disorders Respiratory conditions

What represents the two types of receptors that are found in the adrenergic nervous system? (Select all that apply.)

Alpha receptors Beta receptors

Which receptor does phenylephrine stimulate?

Alpha1

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

Beta-adrenergic blocking drugs

The pharmacology instructor is explaining the mechanisms of action of adrenergic drugs. Which of the following statements could the instructor use to explain the mechanism used by ephedrine?

Both of the above statements accurately describe ephedrine

An 80-year-old patient has been brought to the Emergency Department in shock. The patient is receiving dopamine (Intropin). What potentially serious adverse effect will the nurse monitor for?

Cardiac arrhythmia

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

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 dobutrex for congestive heart failure. What would be most important to monitor in this patient?

Compliance with drug regimen

A nurse is caring for a male client who is being given an adrenergic drug for shock. Which action should the nurse do?

Continually assess the client for physiological changes and notify the primary care provider with relevant changes.

Use of beta-adrenergic blocking drugs (e.g., propranolol) may have what effect?

Decreasing the effectiveness of epinephrine in cases of anaphylaxis

Adrenergic drugs have three mechanisms of action. Please choose the appropriate three from the list below.

Direct receptor stimulation Indirect receptor stimulation Mixed-acting receptor stimulation

A patient is prescribed regular doses of epinephrine. Which of the following nursing diagnoses is related to comfort and would be most appropriate for this patient?

Disturbed Sleep Pattern, Insomnia Related to CNS Excitation

Which would the nurse identify as a naturally occurring catecholamine?

Dopamine

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

Ephedra

A patient comes to the clinic complaining of seasonal rhinitis. What adrenergic agonist would be prescribed for treatment of seasonal rhinitis?

Ephedrine (Pretz-D)

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 of the following is the adrenergic drug of choice for treatment of anaphylactic shock?

Epinephrine

Which would the nurse expect to be given to a patient experiencing acute bronchospasm?

Epinephrine

______________ is the prototype of the adrenergic drugs.

Epinephrine (Adrenalin)

Stimulation of beta1 adrenergic receptors in the heart results in:

Increased heart rate

Which is an effect of epinephrine?

Increased heart rate

Excessive use of ephedrine and pseudoephedrine can lead to toxicity. Although hemoperfusion is not effective in clearing these drugs from the body, urinary acidification may enhance their elimination. Which of the following statements explains why urinary acidification is not routinely used?

It presents the risk of renal damage

Clinical indications for the use of adrenergic drugs stem mainly from their effects on the heart, blood vessels, and bronchi. They are often used as emergency drugs. For which of the following conditions would these drugs be used? Choose all that apply.

Myocardial infarction Asthma attack Anaphylaxis

Which of the following is the primary neurotransmitter of the sympathetic nervous system? (Choose one)

Norepinephrine

A client 16 years of age arrives at the emergency department (ED) saying she was stung by a bee and used her EpiPen prior to arriving in the ED. She is breathing well now. What would the nurse do next for this client?

Obtain from her, and those who were with her, as much information about the bee sting (and her physical reaction to the bee sting) as possible

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

A nurse is teaching a patient to self-administer inhaled epinephrine for bronchodilation. Which of the following topics should be included in the nurse's instruction?

Proper use of a nebulizer or inhaler

Which of the following is an effect of systemic administration of phenylephrine?

Reflex bradycardia

A patient is brought to the emergency department for treatment of noncatecholamine adrenergic drug toxicity. What is the primary clinical manifestation of noncatecholamine adrenergic drug toxicity?

Severe hypertension

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

Sympathetic nervous system

A 6-year-old client is given parenteral epinephrine for the treatment of bronchospasm. The nurse understands that children may experience what condition secondary to parenteral epinephrine?

Syncope

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 male client takes a nasal adrenergic medication for his allergic rhinitis. Part of the nurse's education plan should include information that overuse of adrenergic drugs may cause what effect?

Tolerance

The nurse encourages people to limit use of OTC epinephrine products to prevent the occurrence of what problem?

Tolerance

Activation of beta3-adrenergic receptors produces lipolysis and increased release of free fatty acids into the blood. True or false?

True

The predominant clinical effect in response to activation of beta2 receptors is bronchodilation. True or false?

True

The predominant effect in response to activation of alpha-1 receptors by an adrenergic drug is vasoconstriction. True or false?

True

The predominant effect in response to activation of beta1 receptors in the heart is cardiac stimulation. True or False?

True

Epinephrine causes relaxation of:

bronchioles