Chapter 15: Adrenergic Agonists and Antagonists

A patient has been prescribed atenolol. To ensure safe dosing, the nurse teaches the patient to frequently assess what parameter? A) daily weight B) heart rate C) urine output D) body temperature

B) heart rate

A nurse is administering epinephrine to a patient during cardiac arrest. The primary desired action of this medication is to: A) stimulate a heart rate B) decrease cerebral blood flow C) initiate respirations D) increase blood flow to the kidneys

A) stimulate a heart rate

Which is the highest priority nursing intervention for a patient who is starting on metoprolol? A) peripheral pulses B) respiratory rate C) urinary retention D) lung sounds

A) peripheral pulses Decreased cardiac output puts the patient at highest risk. This will be evident by the assessment of peripheral pulses.

The nurse will monitor the patient taking albuterol for which conditions? (Select all that apply) A) palpitations B) hypertension C) hypoglycemia D) bronchospasm E) uterine contractions

A) palpitations B) hypertension D) bronchospasm

The nurse is preparing to discharge a patient who is receiving acebutolol HCl. Which instruction will the nurse include in the medication teaching plan for this patient? A) "if you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions" B) "if you become dizzy, do not take your medication for 2 days and then restart on the third day" C) "this medication may make you fatigued; increasing caffeine in your diet may help alleviate this problem" D) "increase intake of green leafy vegetables to prevent bleeding problems that can be caused by this medication"

A) "if you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions" Acebutolol HCl, a beta blocker, has negative chronotropic effects and could cause symptomatic bradycardia and/or heart block. The health care provider should be consulted before acebutolol is administered to a patient with bradycardia (heart rate less than 60 beats/min).

A nurse is preparing to administer a beta blocker to a patient. The nurse recognizes that beta blockers are used to treat which conditions? (Select all that apply) A) angina pectoris B) cardiogenic shock C) chronic obstructive pulmonary disease (COPD) D) congestive heart failure (CHF) E) hypertension F) sinus bradycardia

A) angina pectoris D) congestive heart failure (CHF) E) hypertension Beta blockers are effective in treating hypertension (secondary to negative inotropic effects) and angina pectoris (decreases cardiac workload when decreasing heart rate and contractility). Beta blockade has also been shown to reduce mortality in patients with CHF.

A patient with cardiac decompensation is receiving dobutamine as a continuous infusion. The patient's blood pressure has increased from 100/80 mm Hg to 130/90 mm Hg. What is the nurse's priority action? A) assess hourly blood pressure readings B) assess the patient's ECG and slow the infusion C) assess the patient's respiratory rate and measure ABGs D) assess the patient's I&O and decrease IV fluids

A) assess hourly blood pressure readings The major therapeutic effect of dobutamine is to increase cardiac output. Cardiac output is reflected in the patient's heart rate, blood pressure, and urine output. An increase in blood pressure is the expected therapeutic effect.

A patient is prescribed metoprolol to treat hypertension. It is important for the nurse to monitor the patient for which condition? (Select all that apply) A) bradycardia B) hypotension C) ankle edema D) decreased respirations E) increased respirations

A) bradycardia B) hypotension

Which finding would indicate to the nurse that a medication has activated alpha 1 receptors? A) increase in blood pressure B) pupillary constriction C) bradycardia D) increased saliva production

A) increase in blood pressure

The nurse assesses a patient receiving an adrenergic (sympathomimetic) agent. Which finding will be of greatest concern to the nurse? A) weak peripheral pulses and decreased heart rate B) increased peripheral pulses and increased heart rate C) stable blood pressure and increased cardiac output D) heart rate of 95 beats per minute and strong peripheral pulses

A) weak peripheral pulses and decreased heart rate Adrenergic agents stimulate the sympathetic nervous system, which increases heart rate (positive chronotropic effect), contractility (positive inotropic effect), and conductivity (positive dromotropic effect). The nurse would be most concerned that the pulses remain weak and heart rate decreased after receiving this drug, as the therapeutic effect is not being achieved.

The nurse is administering atenolol to a patient. Which concurrent drugs does the nurse expect to most likely cause an interaction? (Select all that apply) A) ginseng supplement B) a nonsteroidal antiinflammatory drug (NSAID), such as aspirin C) atropine, an anticholinergic D) haloperidol E) methyldopa

B) a nonsteroidal antiinflammatory drug (NSAID), such as aspirin C) atropine, an anticholinergic Look at orange chart on pg. 207 in the textbook.

Stimulation of which adrenergic receptor results in dilation of vessels and decrease in blood pressure? A) alpha 1 B) alpha 2 C) beta 1 D) beta 2

B) alpha 2

When teaching a patient who has been prescribed metoprolol about side/adverse effects, which is the highest priority teaching point? A) report any complaints of stuffy nose B) instruct the patient how to take a pulse C) check for bladder distention D) warn of possible impotence and decreased libido

B) instruct the patient how to take a pulse One potential side effect of metoprolol is bradycardia (slow heart rate).

A patient who is taking epinephrine is also taking several other medications. The nurse should realize that there is a possible drug interaction with which drugs? (Select all that apply) A) albuterol B) metoprolol C) propranolol D) digoxin E) methyldopa

B) metoprolol C) propranolol D) digoxin E) methyldopa Look at orange chart on pg. 202 in the textbook.

A patient has been taking metoprolol and tells the home care nurse, "I can't afford this medication any more, and I stopped it yesterday." What is the nurse's priority action? A) refer the patient to the social worker B) call the drug company to ask for assistance C) assess the patient's blood pressure D) teach the patient that abrupt medication withdrawal may lead to a rebound hypertensive crisis

C) assess the patient's blood pressure Abrupt withdrawal of a beta blocker can cause rebound hypertension. The nurse should immediately check the patient's blood pressure and then proceed with teaching and calling the health care provider.

Nadolol is prescribed for a patient. The nurse realizes that this drug is a beta-adrenergic blocker and that this drug classification is contraindicated for patients with which condition? A) hypothyroidism B) angina pectoris C) bronchial asthma D) liver dysfunction

C) bronchial asthma

The nurse is teaching the patient about the side effects of atenolol. These include: A) pupillary constriction B) blood vessel dilation C) bronchospasm D) tachycardia

C) bronchospasm

Which finding would indicate to the nurse that a medication has activated beta 2 receptors? A) uterine contractions B) bronchiolar constriction C) hyperglycemia D) increased saliva production

C) hyperglycemia

The nurse realizes that beta 1 receptor stimulation is differentiated from beta 2 stimulation in that stimulation of beta 1 receptors leads to which condition? A) increased bronchodilation B) decreased uterine contractility C) increased myocardial contractility D) decreased blood flow to skeletal muscles

C) increased myocardial contractility

A patient is receiving dopamine intravenously. Which drug should the nurse have available to treat extravasation and tissue necrosis? A) norepinephrine bitartrate B) nadolol C) phentolamine mesylate D) clonidine

C) phentolamine mesylate

The nurse is caring for a patient who has been recently diagnosed with hypertension and is to receive an initial dose of atenolol. What is the nurse's primary intervention? A) assess the patient's urinary output B) teach the patient to change positions slowly C) encourage an increase in fluid intake D) assess for history of any respiratory disease

D) assess for history of any respiratory disease

The nurse is caring for a patient diagnosed with heart failure and chronic obstructive pulmonary disease (COPD). The patient is ordered a nonselective beta blocker. What is the nurse's primary intervention? A) assess the heart rate before administration B) maintain the patient on intake and output C) make sure the patient is on telemetry monitoring D) call the health care provider to request a different medication

D) call the health care provider to request a different medication Nonselective beta blockers are used to treat supraventricular dysrhythmias secondary to their negative chronotropic effects (decreasing heart rate). They may exacerbate heart failure and COPD. The patient could receive a selective beta blocker instead. The nurse should make the health care provider aware of the patient's history of respiratory disease.

A patient is given epinephrine, an adrenergic agonist (sympathomimetic). The nurse should monitor the patient for which condition? A) decreased pulse B) pupil constriction C) bronchial constriction D) increased blood pressure

D) increased blood pressure

The nurse assesses the peripheral intravenous infusion site of a patient receiving intravenous dopamine and suspects extravasation. What is the nurse's primary action? A) apply a cold pad to the site B) pull the IV immediately C) elevate the patient's extremity D) stop the infusion

D) stop the infusion The nurse's first action is to stop the infusion, followed by infusing phentolamine into the area to counteract vasoconstrictive effects of the dopamine.

The nurse is caring for a patient who is prescribed propranolol. Which assessment finding will reveal if the medication is having a therapeutic effect? A) the patient's lung sounds are clear B) the patient is in sinus rhythm C) the patient has strong peripheral pulses D) the patient's blood pressure is 130/75 mm Hg

D) the patient's blood pressure is 130/75 mm Hg Propranolol is nonselective—it blocks both beta 1 and beta 2 receptors