NUR 3420 Pharmacology PrepU Chapter 29

Which would the nurse identify as a naturally occurring catecholamine?

dopamine

A nurse is caring for a client who has been receiving an adrenergic medication. Which statement by the client alerts the nurse about an adverse effect of the medication and a reason to call the prescriber?d

"i feel a "fluttering" feeling in my heart"

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 - Respiratory conditions - Allergic disorders

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 -respiratory conditions - allergic disorders

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 adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction?

B1 receptors

A nurse is caring for a 25-year-old 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 changes

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

Decreasing the effectiveness of epinephrine in cases of anaphylaxis

An 80-year-old patient in the emergency department is receiving dopamine for treatment of shock. Which of the following adverse effects could the patient experience?

Dysrhythmia

You are the nurse in the emergency department who is caring for a patient recently admitted with a myocardial infarction. The patient's heart is pumping an inadequate supply of oxygen to the tissue. What would you assess for?

Dysrhythmias

You are caring for a patient in the ICU whose condition is deteriorating. You receive orders for dopamine, which is an intravenous vasoactive drug. What would be your priority assessment and interventions specific to the administration of vasoactive medications?

Frequent vitals, monitoring the central line site, and providing accurate drug titration

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

Reflex bradycardia

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

When caring for a client in shock, one of the major nursing goals is to reduce the risk that the client will develop complications. What does this require the nurse to do?

Understand the underlying mechanisms of shock, recognize the subtle and more obvious signs, and then provide rapid assessment and response

You are caring for a patient in shock whose condition is deteriorating. You are infusing IV fluids and giving medications as ordered. What type of medications are you most likely giving to this patient?

adrenergic drugs

Which type of shock occurs from an antigen-antibody response?

anaphylactic

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

beta 2

Epinephrine is the drug of choice for treatment of anaphylactic shock. Epinephrine acts by stimulating

beta receptors

A client is admitted to the emergency department with signs and symptoms of cardiogenic shock. Isoproterenol (Isuprel) is administered intravenously. What assessment should the nurse prioritize when monitoring for therapeutic effects?

blood pressure

Epinephrine typically demonstrates the potential to promote relaxation of muscles in what structure?

bronchiole

Epinephrine causes relaxation of:

bronchioles

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

bronchodilation

Mr. Seeman, 65 years old, is admitted to the hospital for cardiogenic shock. He is placed on dopamine to improve his blood pressure. He also has a history of peripheral vascular disease, hyperlipidemia, and diabetes mellitus type 2. What adverse effect(s) would require health care provider notification?

changes in temperature or color of skin

You are caring for a patient in hypovolemic shock. What is a priority nursing action for this client?

check blood pressure and pulse

You are admitting a patient with a diagnosis of a gastrointestinal bleed who is in the compensatory stage of shock. You know that an early sign that accompanies initial shock is what?

cool, clammy skin

In which type of shock does the patient experience a mismatch of blood flow to the cells?

distributive

You are caring for a client who is in neurogenic shock. You know that this is a subcategory of what kind of shock?

distributive

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

Your 25-year-old patient presents to the ED status post-MVA with hypotension, tachycardia, diaphoresis, pallor, and oliguria. Reports from the accident site indicate significant blood loss from the vehicle's only occupant. What type of shock is your patient demonstrating?

hypovolemic

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

An adrenergic drug would be prescribed to produce what physiological effect?

increased heart rate

Which is an effect of epinephrine?

increased heart rate

You are caring for a patient in the compensation stage of shock. You know that in this stage of shock epinephrine and norepinephrine are released into the circulation. What positive effect does this have on your patient?

increases myocardial contractility

In the field, emergency personnel are quick to treat the signs and symptoms of shock because it can quickly lead to organ failure and death. What causes the generalized metabolic acidosis?

insufficient perfusion

The nurse is writing a plan of care for a client receiving an alpha-specific adrenergic agonist. What is the priority component of client's plan of care?

monitor blood pressure and heart rate frequently

The ICU nurse is caring for a patient in shock. What is one of the most important functions of the nursing role in caring for this patient?

monitoring for complicating and side effects of treatment

The nursing instructor is discussing shock with the senior nursing students. The instructor tells the students that shock is a life-threatening condition. What else should the instructor tell the students about shock?

occur when arterial blood flow and oxygen delivery to tissues and cells are inadequate

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

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

You are caring for an 88-year-old client who was admitted to the ICU. The patient is suspected of being in cardiogenic shock. Which of the following observations could indicate that the patient is in shock?

systolic blood pressure of 80 mm Hg

In a state of shock, compensatory mechanisms occur in the body. What is a compensatory mechanism to increase cardiac output during hypovolemic states?

tachycardia

Your 69-year-old patient is started on IV dopamine for management of hypotension following open-heart surgery. As you care for the patient, you monitor him for adverse effects of the drug, including

tachycardia

A 4-year-old is admitted to the emergency department in shock after a motor vehicle accident. The client weighs 12.5 kg. What would be the minimum effective dose of adrenalin if the pediatric dose is 0.005 to 0.01 mg/kg IV?

62.5 mcg

Adrenergic drugs increase the potential risk for what adverse effect?

cardiac dysrhythmias

An understanding of the pathophysiologic rationale behind shock is something every nurse needs to have. Which of the following statements best describes the pathophysiology for shock?

cells lack an adequate blood supply and are deprived of oxygen and nutrients

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

epinephrine

You are assessing your patient. When prioritizing the patient's care, you recognize that your patient is at risk for hypovolemic shock when

fluid circulating in the blood vessels decreases

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

sympathetic

A nurse is preparing to administer an adrenergic agent for shock. Which nursing assessment should be completed quickly and accurately?

vital signs

The stimulation of beta1 adrenergic receptors in the heart by epinephrine would cause what result?

increased heart rate

A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond?

restore and maintain adequate tissue perfusion

The nurse anticipates that the immunosuppressed patient is at greatest risk for which type of shock?

septic

Your patient, a 16-year-old white male, is an athlete at your local high school. He presents at your office with hypothermia, hypotension, and malaise. His mother indicates he had a skin injury and subsequent fever about a week ago, which subsided after a few days. What type of shock could be involved?

septic

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

true