Adrenergic Blocking Flashcards
Which drug is used to help establish the diagnosis of pheochromocytoma?
a. prazosin (Minipress®)
b. phentolamine (Rogitine®)
c. carvedilol
d. tamsulosin (Flomax®)
ANS: B
Phentolamine is used in the diagnosis of this catecholamine-secreting tumour.
A patient is going home with a new prescription for the β-blocker atenolol (Tenormin®). What important information should the nurse tell the patient about this drug?
a. Never abruptly stop taking this medication.
b. The medication should be stopped once symptoms subside.
c. Change positions slowly to prevent or reduce postural hypotension.
d. Report any weight gain of more than 0.5 kg in a week or any problem with fluid
buildup.
ANS: A
Patients should be weaned off these medications slowly because rebound hypertension and chest pain are possible with rapid withdrawal.
A patient has been on a dopamine drip, and the nurse notices that the infusion has extravasated into the tissue of the forearm. After stopping the infusion, the nurse immediately injects phentolamine into the interstitial catheter. What is the effect of this action?
a. It causes vasoconstriction and rapid uptake of the extravasated dopamine.
b. It causes arterial vasoconstriction and reduced pain and swelling at the site.
c. It increases peripheral vascular resistance and reduces arterial pressure at the site.
d. It increases blood flow to the ischemic site by vasodilation and prevents
permanent tissue damage.
ANS: D
Phentolamine is an α1-blocker that reduces peripheral vascular resistance. Phentolamine 5 mg to 15 mg in 10 mL of normal saline solution is administered into the interstitial catheter prior to removal, to direct phentolamine into the area of extravasation as soon as possible. This action causes α-adrenergic receptor blockade and vasodilation, which in turn increases blood flow to the ischemic tissue and prevents permanent damage.
A 58-year-old male has had a myocardial infarction (MI). He has begun rehabilitation and is ready for discharge. When he is given a prescription for metoprolol (Lopressor®), he becomes upset and says, “I don’t have high blood pressure! Why did my doctor give me this medicine?” What is the nurse’s best explanation to the patient?
a. This medication prevents emboli that may lead to another MI.
b. β-Blockers are routinely prescribed for all post-MI patients.
c. It is being prescribed to prevent hypertension that often occurs post MI.
d. Studies have shown that this medication greatly increases survival in post-MI
patients.
ANS: D
Because of their cardioprotective properties, β-blockers are frequently prescribed to patients who have suffered an MI. However, some contraindications may preclude the use of β-blockers for all post-MI patients.
A patient has received a prescription for prazosin (Minipress) to reduce urinary obstruction due to benign prostatic hyperplasia (BPH). What important information about this medication should the nurse give this patient?
a. Fluids should be restricted while on this medication.
b. Take the medication with breakfast to promote the maximum effects of the drug.
c. Until a tolerance is built up, lightheadedness may occur when standing up after sitting or lying down.
d. Blood pressure should be monitored because the medication may cause hypertension due to vasoconstriction.
ANS: C
This medication is used to relieve impaired urinary flow in men with BPH, but it also has antihypertensive effects. Because of these effects, blood pressure may be dramatically lowered, and orthostatic hypotension and lightheadedness may occur until tolerance is developed. Fluids do not need to be restricted while on this medication. The patient needs to maintain adequate fluid intake to prevent urinary tract infection and to stay hydrated. Because of the possibility of lightheadedness, the first few doses should be taken at bedtime.
A female patient has been admitted to the emergency department after an accidental overdose of an α-blocker. Her daughter states that her mother called to tell her that she had taken two double doses that morning because the headache “just would not go away.” The patient is now dizzy, nauseated, and very weak. What should the nurse do immediately?
a. Administer activated charcoal
b. Force intravenous and oral fluids
c. Empty the stomach by gastric lavage
d. Administer a cathartic such as sorbitol
ANS: C
In an acute oral α-blocker overdose, the patient’s stomach should be emptied, usually by gastric lavage.
Which β-blocker is indicated for the treatment of heart failure?
a. atenolol (Tenormin)
b. carvedilol
c. acebutolol (Sectral®)
d. esmolol (Brevibloc®)
ANS: B
Certain β-blockers, such as carvedilol and metoprolol, have had the best results to date in the treatment of heart failure.
The nurse is teaching a patient about self-monitoring while taking a β-blocker at home. The nurse should teach the patient to measure apical pulse daily for 1 minute. What does the nurse instruct the patient to do if the pulse rate decreases to less than 60 beats per minute?
a. Contact the physician for instructions.
b. Reduce the dose of the β-blocker by half.
c. Continue the medication, because this is an expected effect.
d. Skip the medication dose that day and check the pulse again the next day.
ANS: A
Cardiac depression can occur with β-blockers; thus, patients should be told to contact their physician if their pulse rate decreases to less than 60 beats per minute.
A 49-year-old male patient is in the clinic for a follow-up visit 6 months after starting a β-blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an “embarrassing problem.” What problem with this medication most likely caused him to stop taking it?
a. Urge incontinence
b. Dizziness when standing up
c. Excessive flatus
d. Erectile dysfunction
ANS: D
Erectile dysfunction is a potential adverse effect of β-blockers and may cause patients to stop taking them.
Indicate the appropriate medication in the top list for each condition listed in the lower list.
a. An α-blocker drug
b. A β-blocker drug
c. Both an α-blocker drug and a β-blocker drug
1. Migraine headaches
2. Benign prostatic hyperplasia
3. Glaucoma
- ANS: B
- ANS: A
- ANS: B
