Pharmacolog test 2- Adrenergic AgonistsDrugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following?
Drugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following?
Sympathomimetics Explanation: Sympathomimetics are drugs that produce activity similar to the neurotransmitter norepinephrine. Drugs that block or inhibit the sympathetic nervous system are called antiadrenergic drugs, adrenergic blocking drugs, or sympatholytics.
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 Explanation: The nurse must immediately report to the health care provider a fall in systolic blood pressure below 100 mm Hg. Epinephrine should raise the blood pressure, so a continued low systolic pressure indicates the medication has not been effective. A diastolic blood pressure of 75 mm Hg, a pulse rate of 60 beats per minute, and a temperature reading of 97.6°F are normal and need not be reported immediately.
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 Explanation: Phenylephrine is an alpha-1 adrenergic agonist and a drug commonly used topically for relief of nasal and nasopharyngeal mucosal congestion and to produce mydriasis for ophthalmologic procedures. Phenylephrine acts as a vasopressor causing vasoconstriction of the arterioles. The vasoconstriction from phenylephrine use can increase peripheral resistance and blood pressure. People with hypertension should not take over-the-counter cold and allergy preparations containing phenylephrine because it can further increase their already elevated blood pressure. Patients with diabetes and gout have not been identified as being at risk for adverse reactions from the use of phenylephrine. A patient with an upper respiratory infection may actually benefit from use of the drug.
In providing care to a client with wheezing, the nurse knows that a medication targets which receptors? Beta 2 Alpha 1 Alpha 2 Beta 1
Beta 2 Explanation: Beta 2 receptors are found on the bronchial smooth muscles, and medications that stimulate beta 2 receptors cause bronchodilation. Alpha 1 receptors cause vasoconstriction of peripheral blood vessels. Alpha 2 receptors decrease tone, motility, and secretions of the GI tract. Beta 1 receptors increase heart rate and force of myocardial contraction.
A client is being treated for asthma. What would the nurse expect to administer?
Beta-2-specific adrenergic agonist Explanation: Most of the beta-specific adrenergic agonists are beta-2-specific adrenergic agonists, which are used to treat and manage bronchial spasm, asthma, and other obstructive pulmonary conditions.
What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction?
Beta-adrenergic blockers Explanation: To counteract the effects of isoproterenol, a beta-specific adrenergic agonist, the nurse would administer a beta-adrenergic blocker.
A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient?
Cardiac arrhythmias
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?
Cardiac monitoring Explanation: The high potential for adverse effects that is associated with the use of dopamine necessitates vigilant cardiac monitoring. Respiratory assessment, ABGs, and monitoring of ICP are likely indicated by the patient's injuries, but these are not directly related to the use of dopamine.
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?
Change in pulse rate Explanation: The nurse should report any changes observed in pulse rate or rhythm immediately. Changes in glucose level, appetite, or temperature need not be reported immediately to the primary care provider unless they are severe.
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 dobutamine for congestive heart failure. What would be most important to monitor in this patient?
Compliance with drug regimen
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?
Continually assess the client for physiological changes and notify the primary care provider with changes. Explanation: When caring for a client receiving an adrenergic medication for shock, the nurse will continually assess the client for changes in his vital signs, perfusion, and any adverse reactions. Telling a family that their loved one might die is not an appropriate nursing action at that time. Seizures, hypothermia, and dementia are not common side effects of adrenergic medications, and an adrenergic medication should not be abruptly stopped. The nurse needs to stay close to a client to do frequent assessments; sleep deprivation may occur, but it is not the primary concern when a client is in shock.
Which would the nurse identify as a naturally occurring catecholamine?
Dopamine
Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm? Epinephrine Dopamine Metaraminol Norepinephrine
Epinepherine Explanation: Epinephrine would be used to treat bronchospasm. Dopamine is indicated for the treatment of congestive heart failure. Metaraminol is used to treat shock if norepinephrine or dopamine cannot be used. Norepinephrine is used to treat shock and during cardiac arrest to promote sympathetic activity.
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 Phenylephrine Albuterol Terbutaline
Epinephrine Explanation: Epinephrine is an alpha- and beta-adrenergic agonist. Phenylephrine is an alpha-specific adrenergic agonist. Albuterol is a beta-specific adrenergic agonist. Terbutaline is a beta-specific adrenergic agonist.
A male client is prescribed an adrenergic ophthalmic medication. What should the nurse include in the teaching plan?
Hypertension may be a side effect of the medication.
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:
Increase BP Explanation: For a client in shock, dopamine helps to increase blood pressure. The alpha stimulation produces increased peripheral resistance, raising the blood pressure as the dose of dopamine increases. The drug's dosage is titrated upward until adequate perfusion of vital organs is achieved. Beta-1 stimulation produces increased cardiac output by increasing the force of contraction and heart rate. The drug does not have a direct effect on body temperature.
A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?
Increased vasoconstrictive effects
A patient is receiving salmeterol. The nurse would expect this drug to be given by which route?
Inhalation Explanation: Salmeterol, a beta-specific adrenergic agonist, is administered by inhalation.
Epinephrine is contraindicated in clients with which diseases or disorders?
Narrow-angle (or closed-angle) glaucoma
The adrenergic branch of the autonomic nervous system is also known by which name?
SNS
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 vasoconstriction, limiting the blood flow to the area.
T/F Phentolamine is the agent used to treat extravasation of dobutamine.
True
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. Explanation: The client's heart rate must be assessed prior to administration of alpha- and beta-adrenergic agonists. There would be no need to check blood glucose or measure urinary output, and though respiratory rate is monitored it is not the priority measure.
Epinephrine causes relaxation of:
bronchioles
A client is taking an OTC allergy product. The nurse would expect to find that this product most likely contains:
phenylephrine