Chapter 30- Adrenergic Agonists
Which is an effect of epinephrine? Peripheral vasodilation Increased heart rate Bronchoconstriction Decreased blood pressure
increased heart rate
Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation? β2 receptors α2 receptors β1 receptors α1 receptors
β2 receptors
An increased dosage of digoxin would be needed if the patient is also taking midodrine. T or F
False Midodrine can precipitate increased drug effects of digoxin; this combination should be avoided.
Which herbs has been removed from most weight-loss medications due to potential legal liability? Gingko Ginseng Ephedra Rose hips
ephedra
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 Temperatures reading of 97.6°F Pulse rate of 60 beats per minute A diastolic blood pressure of 75 mm Hg?
Systolic blood pressure below 100 mm Hg
x Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction? β1 receptors α1 receptors α2 receptors β2 receptors
β1 receptors
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 man who has a diagnosis of primary hypertension A woman who has been admitted with a suspected ischemic stroke A woman who is in labor and may require a caesarean section
A man who is in cardiogenic shock following a myocardial infarction One of the most frequent indications for adrenergic agonist drugs is shock. Their use is contraindicated in labor, and they would exacerbate hypertension.
A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient? Cardiac arrhythmias Urinary retention Elevated temperature Sleeplessness
Cardiac arrhythmias
Which would the nurse identify as a naturally occurring catecholamine? Dobutamine Dopamine Ephedrine Metaraminol
Dopamine Dopamine is a naturally occurring catecholamine. Dobutamine, ephedrine, and metaraminol are synthetic catecholamines.
AAn 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 Phenylephrine Albuterol Terbutaline
Epinephrine
Epinephrine is contraindicated in clients with which diseases or disorders? Asthma Narrow-angle (or closed-angle) glaucoma Hypotension Bronchoconstriction
Narrow-angle (or closed-angle) glaucoma
Which agent would the nurse expect to find when reviewing over-the-counter allergy products? Phenylephrine Midodrine Clonidine Dopamine
Phenylephrine Phenylephrine is found in many cold and allergy products because it is so effective in constricting topical vessels and decreasing the swelling and signs and symptoms of rhinitis.
Drugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following? Sympathomimetics Sympatholytics Antiadrenergic drugs Anticholinergic drugs
Sympathomimetics Sympathomimetics are drugs that produce activity similar to the neurotransmitter norepinephrine.
Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly. T or F?
True
Which receptor does phenylephrine stimulate? Alpha2 Beta1 Beta2 Alpha1
alpha1 Phenylephrine stimulates alpha1 receptors.
Epinephrine causes relaxation of: bronchioles. smooth muscles in the intestinal wall. superficial blood vessels. sphincter muscles.
bronchioles Epinephrine is the adrenergic drug of choice for relieving the acute bronchospasm and laryngeal edema of anaphylactic shock.
A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective? Bronchodilation Decreased heart rate Tremor Slowed cardiac conductivity
bronchodilation
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 glucose level Changes in appetite Changes in temperature Changes in pulse rate
changes in pulse rate
What is the expected outcome when phenylephrine is administered? Select all that apply. decreased peripheral vascular resistance increased systolic blood pressure increased diastolic blood pressure increased cardiac output decreased renal perfusion
decreased renal perfusion increased diastolic blood pressure increased systolic blood pressure
A patient is receiving salmeterol. The nurse would expect this drug to be given by which route? Inhalation Oral Intramuscular Intravenous
inhalation
Adrenergic drugs mimic the effects of stimulating what part of the nervous system? parasympathetic sympathetic autonomic central
sympathetic An adrenergic drug is an agent that produces effects like those produced by stimulation of the sympathetic nervous system and therefore has widespread effects on body tissues.
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 A 52-year-old male with adult-onset diabetes A 17-year-old female with symptoms of an upper respiratory infection A 62-year-old male with gout
A 47-year-old female with hypertension
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? Availability of caregivers Effectiveness of comfort measures Dietary intake Compliance with drug regimen
Compliance with drug regimen
Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm? Epinephrine Dopamine Metaraminol Norepinephrine
Epinephrine
x A male client is prescribed an adrenergic ophthalmic medication. What should the nurse include in the teaching plan? The drug is only absorbed locally. Side effects are limited to inflammation of the conjunctiva. Allergic and adverse reactions are rare. Hypertension may be a side effect of the medication.
Hypertension may be a side effect of the medication.
The nurse is admitting a client with a complex health history who will be prescribed midodrine. The nurse should call the provider to discuss the potentially dangerous combination of midodrine and what drug? Olanzapine Hydrochlorothiazide Oxycodone Ibuprofen
Olanzapine
The nurse would contact the health care provider before administering an adrenergic drug to a client who is also taking which drug? Antibiotic MAO inhibitor Diuretic Analgesic
MAO inhibitor Concurrent use of MAO inhibitors and adrenergic drugs may lead to a danger of cardiac dysrhythmias, respiratory depression, and acute hypertensive crisis, with possible intracranial hemorrhage, convulsions, coma, and death.
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 Subcutaneous Intramuscular Intravenous
Oral
The nurse knows that what is an added benefit of epinephrine in cardiac arrest situations due to asystole or pulseless electrical activity? Increases oxygenation to the brain Stimulates electrical and mechanical activity Reduces seizure activity Increases oxygenation to the myocardium
Stimulates electrical and mechanical activity A benefit of epinephrine in arrest situations due to asystole or pulseless electrical activity is the added ability to stimulate electrical and mechanical activity and produce myocardial contraction.
The adrenergic branch of the autonomic nervous system is also known by which name? Sympathetic nervous system Parasympathetic nervous system Central nervous system Somatic nervous system
Sympathetic nervous system
A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action? assess heart rate. check blood glucose level. measure urine output. monitor respiratory rate.
assess heart rate
What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction? Beta-adrenergic blockers Sympathomimetic agents Narcotic antagonist Neuromuscular blocking agent
beta-adrenergic blockers Why? To counteract the effects of isoproterenol, a beta-specific adrenergic agonist, the nurse would administer a beta-adrenergic blocker.
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: decrease heart rate. decrease blood pressure. increase blood pressure. increase body temperature.
increase blood pressure.
An adrenergic drug would be prescribed to produce what physiological effect? decreased respiratory rate increased heart rate urine concentration decreased blood pH
increased heart rate
Which medication will most likely be administered to a client experiencing anaphylaxis? epinephrine norepinephrine acetylcysteine dantrolene sodium
epinephrine Epinephrine is the adrenergic drug of choice for relief of anaphylactic shock, the most serious allergic reaction, as well as in treatment of cardiac arrest
Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation? β2 receptors α2 receptors β1 receptors α1 receptors
β2 receptors Vasodilation of peripheral vessels and bronchodilation are the result of stimulation of β2 receptors
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? Respiratory assessment Arterial blood gases Monitoring of intracranial pressure Cardiac monitoring
Cardiac monitoring
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? Prepare the family by telling them how sick their loved one is and that he may die. Observe the client closely for seizures, hypothermia, and dementia; if seen, stop the infusion immediately. Continually assess the client for physiological changes and notify the primary care provider with changes. Leave the room so that the client can sleep and not risk sleep deprivation psychosis.
Continually assess the client for physiological changes and notify the primary care provider with changes.
Which adverse effect might a client receiving clonidine exhibit? (Select all that apply.) Photophobia Hyperglycemia Pupil constriction Personality changes Difficulty urinatingt?
Personality changes Photophobia Difficulty urinating
The nurse is administering epinephrine IV push. The nurse checks for patency of the IV prior to administration of the drug. The nurse realizes that if the IV is infiltrated, the medication will result in tissue extravasation. What is the reason for such an occurrence? - The medication causes swelling within the tissues, impairing blood flow to the site. - The medication causes venous congestion and pooling of blood in the tissues. - The medication causes vasoconstriction, limiting the blood flow to the area. - The medication causes an allergic response at the site of infiltration, leading to swelling and erythema.
The medication causes vasoconstriction, limiting blood flow to the area. Extravasation can occur during parenteral administration; necrosis may result because of epinephrine's potent vasoconstrictive properties.
Phentolamine is the agent used to treat extravasation of dobutamine. T or F
True Maintain phentolamine on standby in case extravasation occurs.
A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce? decreased cerebral circulation decreased coronary circulation increased vasoconstrictive effects increased bronchoconstriction
increased vasoconstrictive effects Epinephrine is added to local anesthetics for vasoconstrictive effects, which include prolonging the action of the local anesthetic drug, preventing systemic absorption, and minimizing bleeding.