Pharm Ch. 18. Adrenergic Drugs

Which alpha-adrenergic receptor stimulant temporarily relieves conjunctival congestion by arteriolar vasoconstriction?

Naphazoline

The nurse recognizes that a patient who has been placed on midodrine has a clear understanding of how to administer the medication when the patient states that the last dose of the medication will be taken when?

No later than 6:00 p.m.

The nurse is reviewing a patient's medical history and recognizes which conditions as usual contraindications to the use of adrenergic medications? Select all that apply.

Drug allergy Hypertension

The nurse administering alpha-adrenergic medications will monitor the patient closely for which adverse effects? Select all that apply.

Dry mouth Tachycardia Restlessness

Which information is most important for the nurse to give to the patient regarding an ophthalmic form of a beta-adrenergic agonist drug?

"Do not allow the eyedropper to touch the eye when administering the medication."

During a cardiopulmonary resuscitation emergency, the nurse expects to administer which injectable, fast-acting medication?

Epinephrine

Which medication is an example of a direct-acting sympathomimetic?

Epinephrine

The health care provider has prescribed lidocaine with epinephrine for injection to be administered before obtaining a biopsy. The nurse would question the prescription after the patient makes which statement?

"I am taking a new medicine for high blood pressure."

Which statement indicates that the patient understands how to take salmeterol for asthma symptoms?

"I will give myself one puff twice a day at 7 AM and 7 PM."

Which patient statement indicates an understanding of the importance of administering the midodrine according to specified instructions?

"I will take the first dose in the morning with a full glass of water before I get out of bed."

Which patient statement indicates understanding of how to appropriately self-administer a corticosteroid inhalant and a bronchodilator for asthma symptoms?

"I will use the bronchodilator first, wait 5 minutes, and then use the corticosteroid inhalant."

Which patient is at greatest risk for experiencing an adverse reaction to the two adrenergic drugs?

A 72-year-old who has an ophthalmic condition

A patient has been ordered a new medication in the form of an inhalant. The patient tells the nurse that the inside of her mouth is irritated. Which instruction is most important for the nurse to give the patient?

"Rinse your mouth thoroughly after using the medication."

A patient has been ordered two drugs of the same class to be used for treatment of asthma. The patient asks the nurse, "Why do I have to use more than one medication to treat this? Isn't one enough?" Which statement is by the nurse is an appropriate response?

"Sometimes use of more than one drug will give a combined therapeutic effect."

A patient is being treated with epinephrine in a code situation. The nurse finds a solution marked "epinephrine 1:10,000" on the crash cart. Which phrase describes what the nurse interprets the strength of the medication to be?

0.1 mg of medication contained in 1 mL of solution

The nurse would instruct a patient to take oral midodrine at which time?

0700

Epinephrine 1 mg intravenous (IV) push is ordered for a patient during a cardiac emergency situation. Epinephrine 1:10,000 strength is available. How many milliliters will the nurse administer? _______________ mL

10 mL

A patient taking alpha-adrenergic medication who complains of a dry mouth is experiencing which phenomena?

An expected side effect of the medication

Where are beta2-adrenergic receptors located in the body? Select all that apply.

Arterioles Bronchioles Visceral organs

Which action would the nurse take when a 79-year-old patient who receives a beta-adrenergic agonist complains of chest pain?

Ask the patient to rate pain intensity.

A patient with cardiac decompensation is receiving dobutamine as a continuous infusion. The patient's blood pressure has increased from 100/70 mm Hg to 130/80 mm Hg. Which action would the nurse take while the patient is receiving this infusion?

Assess frequent blood pressure readings.

Which information would be included when teaching an older adult about use of a beta-adrenergic agonist medication? Select all that apply.

Avoid excessive stress and heat. Slowly change positions from lying to sitting to standing. Monitor and record your blood pressure and heart rate at home. Seek immediate medical attention for chest pain, palpitations, or seizures.

Which assessment would be completed prior to administering an adrenergic agonist?

Blood pressure

The nurse recognizes that which condition is an indication for the use of norepinephrine?

Cardiogenic shock

Which assessment needs to be completed before the nurse administers a positive chronotropic medication?

Check apical pulse.

Which action would be most important for the nurse to take while administering dopamine intravenously?

Check the patient's intravenous site hourly for infiltration.

Which action would the nurse perform to help prevent infiltration of a dopamine infusion site?

Check the site every hour for evidence of swelling.

When administering adrenergic agonist medications to an older adult, the nurse will monitor this patient closely because of which common physiologic changes found in this age group? Select all that apply.

Diminished stroke volume of the heart Decline in efficiency of the heart muscle

The nurse would obtain which ophthalmic medication to administer before a diagnostic eye examination?

Dipivefrin

To produce a sympathomimetic response, the nurse may administer which medication that is only available as a synthetic substance?

Dobutamine

Which are examples of endogenous catecholamines? Select all that apply.

Dopamine Epinephrine Norepinephrine

A patient diagnosed with asthma just completed an albuterol nebulizer treatment. The patient tells the nurse, "I feel like my heart is fluttering, and my hands are very shaky." Which action would the nurse take?

Explain this sensation as a side effect.

The nurse will prepare the patient for administration of tetrahydrozoline by performing which action?

Gently pulling down on the lower eyelid

A patient who is taking a monoamine oxidase inhibitor (MAOI) for is scheduled to begin treatment with an adrenergic drug. Which action would the nurse take?

Hold the dose of the adrenergic drug and notify the health care provider of the use of the MAOI medication.

Which effect does the nurse expect in the patient with heart failure after administration of dobutamine?

Increased cardiac contractility

Which outcome would be appropriate to establish for patients taking beta1 agonists?

Increased contractility of myocardium

Which response is elicited by the activation of beta1 receptors located on the sinoatrial node?

Increased heart rate

Which assessment will indicate the patient is having the expected therapeutic effect of intravenous epinephrine medication?

Increased heart rate and strong pulse

Which laboratory test would a nurse anticipate for a patient receiving alpha-adrenergic medication?

Increased level of glucose

Which effect is a result of beta1-adrenergic-receptor stimulation?

Increased renin secretion

Which medications will a nurse question so as not to aggravate a diagnosis of mitral valve regurgitation? Select all that apply.

Midodrine Phenylephrine Norepinephrine

Which assessments will the nurse note when administering an alpha1 agonist to a postpartum patient? Select all that apply.

Monitor pulse rate. Assess blood pressure. Palpate fundal firmness.

Which action would the nurse take if a patient's blood pressure is 160/90 mm Hg and the patient is to receive an adrenergic drug for asthma?

Notify the health care provider of the patient's elevated blood pressure reading.

A patient who was recently prescribed an adrenergic medication now complains of itching in both legs. Which action would the nurse take?

Notify the health care provider.

Which medication would the nurse recommend for the patient to take while experiencing an episode of epistaxis?

Oxymetazoline

Which statement is the most accurate outcome criteria for the nurse to use when determining if a patient is responding appropriately to use of an adrenergic drug?

Patient's respiratory rate is 16 breaths/min, and blood pressure is 130/72 mm Hg.

The nurse recognizes that which medication is classified as an alpha-adrenergic agonist?

Phenylephrine

Which are therapeutic expected outcomes of adrenergic agonists? Select all that apply.

Pink skin color +2 peripheral pulses Pulse rate 60 to 100 beats/min

The teaching plan for a patient taking midodrine would include which instruction?

Rise slowly out of bed each morning.

The patient tells the nurse, "I don't understand why my salmeterol inhaler doesn't help when I'm having an asthma attack." The nurse frames the response based on which information?

Salmeterol is not designed to relieve acute symptoms.

When teaching an 83-year-old patient about the effects of adrenergic agonists, the nurse will advise the patient to avoid which activity?

Slow jog in summer

During intravenous (IV) administration of dopamine, the nurse notes a bruise "bluish in color" and edema at the IV insertion site on the patient's right arm. Which action is the nurse's priority?

Stop the dopamine infusion.

The nurse assesses the peripheral intravenous (IV) infusion site of a patient receiving intravenous dopamine and suspects extravasation. Which action will the nurse take?

Stop the infusion.

Which finding would be of concern to the nurse for a patient who is receiving an adrenergic (sympathomimetic) agent?

Weak peripheral pulses and decreased heart rate

Which response is a priority with an older adult who is taking a beta-adrenergic agonist and complaining of headaches?

Take the patient's blood pressure and notify the prescribing health care provider.

Drugs in which class may interact with adrenergic drugs?

Thyroid preparations

The nurse is caring for a patient who has been prescribed dopamine for shock syndrome. The nurse suspects that the patient has acute hypertensive crisis. Which other class of medications will the nurse observe in the patient's medical history?

Tricyclic antidepressants

Which effect is the objective of administering phenylephrine as an adjunct to local anesthesia?

Vasoconstriction