ANS Flashcards
ANS
Composed of central/peripheral nervous system
Central nervous system composed of?
Brain/Spinal Cord
Peripheral nervous system
Somatic skeletal muscle and autonomic!!
Parasympathetic (part of ANS)
Rest/Digest (cholinergic)
Sympathetic
Fight or flight (adrenergic) NE (norepinephrine)
- Alpha 1 & Alpha 2
- Beta 1 & Beta 2
Which clinical manifestations indicate a central nervous system dysfunction?
- Lack of movement in left upper extremity
- Decreased memory
- Increased thirst.
Parasympathetic antagonist injury OR Sympathetic agonist
Dec. secretion of gastric acid.
Increased BP and HR when threatened
Sympathetic
Sympathetic
FIGHT OR FLIGHT.
- Dilates pupils
- Relaxes bronchi, accelerates heart rate, stimulates glucose release by liver, relaxes bladder (AND other sphincters… ), contracts rectum.
Parasympathetic
REST & DIGEST
- Constricts pupil
- stimulates salivation
- Inhibits heart
- Constricts bronchi
- Stimulates digestive activity(!!)
- Contracts bladder
- Relaxes rectum
Given the main functions of the ANS, which nursing action would be a priority consideration in providing care for clients with an autonomic dysfunction?
Monitoring cardiac rhythms
Which assessment finding is reflective of the parasympathetic nervous system?
Frequent bowel movements.
Elevated liver enzymes?
Elevated sympathetic nervous system equals elevated glucose systems.
Pupils 8mm and equal?
Dilated; sympathetic.
Decreased urine output??
Sympathetic nervous system (Increased RAAS = inc. renin = hold on to fluid)
Alpha 1 Receptors!!
When activated it causes vasoconstriction = Inc. BP
Beta 1 Receptors!!
Increased
- Contractility
- HR
- Conduction
Beta 2
Glycogenolysis (inc. glucose)
Inc. renin secretion (dec. urin/hold fluid, inc. BP)
A1 Sphincters
Constriction/ejaculation
Beta 2 Respiratory
Dilation of Bronchioles.
Nonselective Adrenergic Agonists
It will ACTIVATE both Alpha and Beta receptors. Used for allergic anaphylaxis, bronchospasm, cardiac arrest, and severe hypotension. (epi-pen)… inc. BP, hold onto fluid, inc. HR, broncho-dilate.
Ephinephrine (Adrenalin)
Onset: immediate/5 min.
Duration: 1-4 hours
Indications: CPR/anaphylaxis/local vasoconstriction/pupil dilation
Mechanisms of action: stimulates alpha and beta receptors.
Routes: IV/SQ/IM/inhalation.
Adverse Effects: nervousness, tremors, tachycardia, HTN, dysrhythmias, pulm. edema (inc. renin/RAAS), CNS stimulation, Local - necrosis (too little blood flow)
Contraindications:
Closed-angle glaucoma-iris bulges forward and blocks angle drainage causes pressure, CAD (bp inc. HR inc.),
Prego: Category C
A client receives epinephrine for anaphylactic shock. The nurse should be aware of which mechanism by which epinephrine acts?
Directly, by stimulating adrenergic receptors.
Alpha1-Adrenergic Agonist
(Vasoconstriction) Phenylephrine (neosynephrine)
Phenylephrine (neosynephrine)
Onset: 1-2 hrs
Duration: 15min-3 hrs
*Indications: Nasal congestion and hypotension (vasoconstriction).
Mechanism of action: Activates A1-receptors in peripheral nervous system.
Adverse effects:
*Reflex bradycardia , reduced peripheral blood flow, CNS stimulation.
Contra Indications: Severe htn, pre-existing bradycardia, CAD, narrow angle glaucoma
Prego: C
Routes: PO/IM/SQ/IV
Beta Adrenergic Agonist
Isoproterenol (Isuprel) NONSELECTIVE
Isoproteroneol (Isuprel)
Onset: immediate
Duration <1 hr-12 hrs
Indication: Transient heart block, medication will inc. myocardial contraction.
Mechanism: Activates both B1 and B2 (inc. conduction/contractility/HR) and (Bronchodilate and liver/inc. glucose)
Adverse: Dysrhythmias, CNS stimulation, headache/nausea/vomiting
Contraindications: CAD/htn/dysrhythmias/hyperthyroidism/dm
Prego: C
Tocolytics (B2)
Stops contractions and prevents pre-term labor
