Oxygenation

Question 1

Adrenergic agonists take action

Answer 1

Administer IV epinephrine 1mg for cardiac resuscitation and can repeat every 3-5 minutes, follow each dose w/20mL saline flush, normally 1mg over 1 minute, antidote phentolamine, record increasing BP and HR, monitor ECG, report tachycardia/palpitations/dysrhythmias/tremors dizziness/increased BP, assess output offer food

Question 2

Adrenergic agonists patient teaching

Answer 2

Read labels on all OTC cold medicine and diet pills, notify provider if EpiPen is needed more than twice a week, store EpiPen in cool dark place and do not refrigerate, pen must be used immediately w/difficulty breathing/wheezing/hoarseness/hives/itching/swelling of lips and tongue, inspect for particles or discoloration, should not be pink-brown in color

Question 3

Alpha 1 response

Answer 3

Vasodilation: decreases BP; reflex tachycardia might result; mydriasis (constriction of pupil) occurs; suppresses ejaculation; reduces contraction of smooth muscle in bladder neck and prostate gland

Question 4

Beta 1 response

Answer 4

Decrease heart rate; reduces force of contractions

Question 5

Beta 2 response

Answer 5

constricts bronchioles; contracts uterus; inhibits glycogenolysis which can decrease blood glucose

Question 6

Leukotriene receptor antagonist (montelukast) MOA

Answer 6

Binds w/ leukotriene receptors to inhibit smooth muscle contraction and bronchoconstriction.

Question 7

Montelukast interactions

Answer 7

Aspirin, NSAIDS, telithromycin, gemfibrozil, clopidogrel, liver enzymes

Question 8

Leukotriene receptor antagonists teaching

Answer 8

D/C if allergic reaction occurs, monitor hepatic function tests periodically, check w/provider before taking St. John’s wort, black or green tea/guarana may increase stimulation, encourage smoking cessation, wear medic alert bracelet, granule packs must be used w/in 15 min, take in the evening, continue inhaler use

Question 9

Theophylline MOA

Answer 9

relaxes smooth muscle of bronchi, bronchioles, pulmonary blood vessels, by inhibiting enzyme phosphodiesterase resulting in increase in cAMP promoting bronchodilation

Question 10

Theophylline nursing implications

Answer 10

low therapeutic index and narrow range, levels should be monitored frequently, toxicity likely to occur when serum level greater than 20

Question 11

Theophylline contraindications

Answer 11

seizure disorders, cardiac/renal/hepatic diseases