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Chapter 31 PrepU

Terms in this set (44)

Nonselective beta blockers are the drugs of choice for treating hypertension in patients who smoke.
False
The use of an alpha-adrenergic blocker will result in which patient outcome?
Vasodilation
A nurse should observe which clients more carefully during the use of propranolol (Inderal) due to the increase likelihood of adverse reactions? (Select all that apply.)
-Clients with asthma
-Clients with diabetes
-Clients with peptic ulcer disease
A nurse is caring for a patient who has been administered a centrally acting anti-adrenergic drug. The nurse knows that under which condition is the use of a centrally acting anti-adrenergic drug contraindicated?
Active hepatic disease
A patient is experiencing urinary retention. He has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention?
Benign prostatic hypertrophy
A patient has received a dose of dopamine intravenously. The patient's IV was infiltrated, and the dopamine was injected into the subcutaneous tissues. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?
Phentolamine mesylate (Regitine)
A patient has been diagnosed with benign prostatic hypertrophy and has been prescribed prazosin (Minipress) to assist in the treatment of the symptoms. How does this alpha1-blocking agent decrease urinary retention?
The medication inhibits urinary bladder contraction.
A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of:
an adrenergic antagonist.
Propranolol is used in the treatment of which disorders?
All the above (Arrhythmias, Hypertension, and Angina)
A nurse is caring for a 55-year-old client who is receiving sustained-release metoprolol. What statement by the patient would lead the nurse to believe that the client needs additional instruction?
"I can take any over-the-counter pain reliever while on metoprolol."
In which patient is metoprolol mostly likely contraindicated?
A 35-year-old post-MI female with a heart rate of 42 bpm
Which observation might indicate that timolol is achieving the desired effect in a patient?
The patient's intraocular pressure decreases.
A client has been admitted to the cardiac unit for heart failure. The nurse is going to administer carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do?
Call the provider and advise them of the client's blood pressure prior to administering the medication.
A male client diagnosed with bone cancer has an order for clonidine on his chart. The nurse is concerned that this may be a mistake and asks another nurse why clonidine would be ordered for this client. What would be an appropriate response from the second nurse?
"Clonidine is sometimes prescribed for severe pain in cancer clients like this client."
A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart?
Decrease the heart rate
A male client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in his chest. While obtaining his history, the nurse learns that the client stopped taking his medications because he ran out and didn't have funds to fill his prescriptions. The nurse knows that which medications being abruptly stopped could be causing his symptoms?
Labetalol
A patient is receiving sotalol. Which instruction would be most important for the nurse to provide to the patient to ensure maximum effectiveness of the drug?
"Be sure to take the drug on an empty stomach."
Which patient statement indicates the need for additional teaching about propranolol?
"I can stop the drug once my blood pressure is controlled."
Which would a nurse identify as a contraindication for the use of a beta-1 selective blocker?
Sinus bradycardia
Which agent would be the most likely drug of choice for an older adult patient with hypertension who requires an adrenergic blocker?
Bisoprolol
Understanding that beta-blockers are used mainly for cardiovascular disorders, which is not an indication for beta-blocker use?
Cardiac bradydysrhythmia
Most nonselective adrenergic blockers are used to treat hypertension.
True
Prior to the administration of a sympatholytic drug, the nurse should check a patient's blood pressure and:
apical pulse.
A nurse is caring for a patient in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the patient's chart for indications of:
history of acute myocardial infarction.
A patient is experiencing an acute myocardial infarction. The physician orders metoprolol to be given as an intravenous bolus injection. The patient responds, and the physician then orders metoprolol oral therapy. The nurse would expect to administer the first oral dose at which time after the last intravenous bolus dose?
15 minutes
A 71-year-old black woman with a history of diabetes for a follow-up appointment after visiting ED for increased angina. As a beta2 receptor blockade has been prescribed to better control the chest pain, what other teaching is very important about this pharmacological intervention?
Beta2 receptor blockade use results in less effective glucose metabolism, especially when accompanied with anti-diabetic medications.
When administering sotalol to a patient, which would be most appropriate?
Administer the drug before meals.
A patient has been prescribed an adrenergic blocking drug for glaucoma. Which nursing intervention should the nurse follow while educating the patient?
Demonstrate the technique of eye drop instillation.
A client has come to get lab results at the cardiology clinic. The nurse notes that the digoxin level is elevated. The nurse knows that what other medication may be responsible for the increase in digoxin level?
Carvedilol
A patient with diabetes who uses insulin is also receiving labetalol. The nurse would monitor the patient closely for:
hypoglycemia.
The nurse frequently sees mature male clients with BPH seeking treatment for symptoms. After ensuring they do not test positive for prostate cancer, pharmacological intervention is one of a few treatment modalities available. Pharmacokinetics indicate alpha1-blocking agents as a treatment choice due to their:
prevention of smooth muscle contraction in nonvascular tissues.
The oldest and most extensively studied beta-blocker, propranolol, is used to treat a wide variety of conditions. What is an indicated condition for propranolol use? (Select all that apply.)
-Prevention of migraine headache
-Palpation and tremor associated with stage fright
A patient is receiving tamsulosin. The nurse understands that this drug is most likely being given for which reason?
To relax prostatic smooth muscles
A patient is to receive metoprolol. What would the nurse include in the teaching plan for this patient?
"Take this drug with food to help promote its absorption."
A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to:
understand the signs and symptoms of hypoglycemia.
After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify what as a contraindication to using this group of drugs?
Sinus bradycardia
The instructor is preparing a teaching plan for a group of students that describes nonselective beta adrenergic blockers. What would the instructor address? (Select all that apply.)
-Nebivolol
-Pindolol
-Timolol
A patient is diagnosed with a pheochromocytoma. Which medications provide adjunctive therapy in the treatment of hypertension and tachycardia?
Nonselective alpha-blocking agents
A patient with benign prostatic hypertrophy (BPH) has been prescribed tamsulosin. How do alpha1-adrenergic blocking agents, such as tamsulosin, assist in treating the symptoms of BPH?
They inhibit contraction of the urinary bladder.
Which agent would the nurse identify as available only in oral form?
Carvedilol
A patient is suspected of having pheochromocytoma. Which agent would the nurse identify as being used to help diagnose this disorder?
Phentolamine
A 35-year-old female has been diagnosed with hyperthyroidism. Her doctor has prescribed propranolol to achieve which effect?
To decrease heart rate
After administering the oral form of labetalol to a patient, the nurse would monitor the patient for a peak drug effect at which time?
1 to 2 hours
A patient is receiving a beta-1 selective blocker after a myocardial infarction to prevent reinfarction. The nurse understands that the rationale for using the drug would be to:
decrease cardiac workload.
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