Unit 5 Pharm Chapter 31 Flashcards
A community-dwelling client has just told the home health nurse that he or she ran out of the prescribed adrenergic antagonist 5 days ago and has not been able to refill the prescription yet. What is the nurse’s priority action?
A) Educate the client about dangers of abruptly stopping the medication.
B) Perform a comprehensive assessment of the client.
C) Inform the care provider promptly.
D) Arrange for the client to get a medication refill.
B) Perform a comprehensive assessment of the client.
Rationale:All of the listed actions are appropriate. However, an immediate priority is assessing the client’s health status
Adrenergic blockers are often called sympathomimetic agents.
A) TRUE
B) FALSE
B) FALSE
Rationale:Adrenergic blockers are often called sympatholytic agents because they lyse or block the effects of the sympathetic nervous system.
Most nonselective adrenergic blockers are used to treat hypertension.
A) TRUE
B) FALSE
A) TRUE
Rationale:Carvedilol and labetalol are both used to treat hypertension. Only amiodarone is not indicated for hypertension; it is used to treat life-threatening ventricular arrhythmias. So the statement that most are used to treat hypertension is correct. If the statement said “all” then it would be a false statement.
A client is to receive metoprolol. What would the nurse include in the teaching plan for this client?
A) “Take this drug with food to help promote its absorption.”
B) “This drug should likely have no effect on your sexual activity level.”
C) “You should notice an increase in your energy level with this drug.”
D) “This drug causes less dizziness than other similar drugs.”
A) “Take this drug with food to help promote its absorption.”
cRationale:Food increases the bioavailability of the drug and facilitates its absorption. Metoprolol crosses the blood–brain barrier, leading to a possible increase in CNS adverse effects. Metoprolol, like other beta1-selective blockers, can lead to decreased exercise tolerance. Metoprolol, like other beta1-selective blockers, can lead to decreased libido and impotence.
Beta1-selective blockers should be gradually tapered over 2 weeks to prevent the risk of severe hypertension or stroke.
A) FALSE
B) TRUE
B) TRUE
Rationale:If these drugs are stopped abruptly after long-term use, there is a risk of severe hypertension, angina, MI, and stroke because the receptor sites become hypersensitive to catecholamines after being blocked by the drug.
The nurse has administered a client’s prescribed adrenergic agent and would anticipate what physiologic effect?
A) Increased catecholamine levels
B) Increased serum pH
C) Decreased renal perfusion
D) Decreased renin levels
D) Decreased renin levels
Rationale:Renin levels would decrease with suppression of the sympathetic nervous system. Renal perfusion increases due to blockage of norepinephrine’s effect at the alpha- and beta-receptors in the sympathetic nervous system. Serum pH is unaffected, and catecholamine levels do not increase in response to adrenergic blockers.
Nonselective beta-blockers are the drugs of choice for treating hypertension in clients who smoke.
A) TRUE
B) FALSE
B) FALSE
Rationale:Beta1-selective blockers, because they do not block the sympathetic bronchodilation, are the preferred drugs for treating hypertension in clients who smoke
The nurse is assessing the client for adverse CNS effects after administering a nonselective adrenergic blocker based on the understanding that these effects occur due to what action?
A) Loss of vascular tone
B) Vasodilation of the mucous membrane vessels
C) Blockage of norepinephrine’s effect
D) Increased parasympathetic dominance
C) Blockage of norepinephrine’s effect
Rationale:CNS effects occur with nonselective adrenergic blockers because the effects of norepinephrine are blocked in the CNS. GI effects of a nonselective adrenergic blocker are related to parasympathetic dominance. Cardiovascular effects occur with nonselective adrenergic blockers because of the lack of stimulatory effects and loss of vascular tone in the cardiovascular system. Respiratory effects occur with nonselective adrenergic blockers because of the loss of bronchodilation and vasodilation of the mucous membrane vessels.
What aspect of a client’s health history would contraindicate the use of a nonselective adrenergic blocker?
A) Hypothyroidism
B) Peripheral vascular disease
C) Cholelithiasis
D) Heart block
D) Heart block
Rationale:Heart block is a contraindication to the use of a nonselective adrenergic blocker because it could be worsened by the slowed heart rate and slowed conduction. None of the other listed conditions would contraindicate the use of a nonselective adrenergic blocker.
