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Pharm quiz 3
Autonomic NS, inflammation and drugs
Terms in this set (29)
The nurse receives a new order for propranolol 80mg po for a patient with hypertension. Which of the other patient's conditions would give concern?
Propranolol is a non-selective beta blocker, which may decrease blood pressure but can also cause bronchoconstriction, not desirable in a asthmatic patient
The primary neurotransmitter for the parasympathetic nervous system is acetylcholine True or False?
Activation (stimulation) of a cell receptor speeds up a physiologic process, regardless of whether the receptor is part of the sympathetic or parasympathetic system.
Activation of a cell receptor will initiate some activity of that cell; whether the result is speeding or slowing a physiologic process depends on the type of cell.
Which neurotransmitters are adrenergic catecholamines?
Epinephrine and Norepinephrine
Which of the following is likely to result from administration of atropine?
Pupillary dilation and decrease of secretions
-Atropine speeds the heart rate, decreases respiratory secretions, dilates the pupils, and reduces GI secretion and motility.
Beta 1 receptors are located primarily:
In the heart
Which of the following are results of stimulating the parasympathetic nervous system?
Slowed heart rate
Increased GI secretions and motility
Stimulation of beta 2 receptors results in:
What is the primary action of an anticholinesterase drug such as physostimine or neostygmine?
Generating a cholinergic response
-blocking the substance which would break down acetylcholine allows it to remain in the synapse longer, generating a stronger effect
Dopamine is used in shock states to elevate the blood pressure while minimizing damage to the kidneys True or False?
Dopamine generally causes vasoconstriction (elevating the blood pressure) but "spares" the renal arteries, maintaining blood flow to the kidneys.
Which receptor sites does Epinephrine act upon?
a. Alpha 1 & Alpha 2 receptors
b. Beta 1 receptors
c. Beta 2 receptors
d. Dopamine receptors
e. All of the above
e. All of the above
Which action is a purpose of the inflammatory process?
To provide a response to any injury or invasion to limit damages
What is the vascular effect of histamine released from mast cells?
-Histamine, when released from mast cells, causes vasodilation. It does not cause platelet adhesion, initiation of the clotting cascade, or increased endothelial adhesiveness.
During inflammation, edema occurs due to the emigration of neutrophils to the area of injury. True or false?
Chemotaxis during the inflammatory response serves to stimulate smooth muscle contraction in the vascular walls. True or false?
Which of the following might the nurse expect to most likely impair the inflammatory process?
Impaired circulation to the area of injury
In the early stages of inflammation, the most predominant cellular responses is with the neutrophils. True or false?
Which manifestation of inflammation is systemic?
Fever and leukocytosis
-The only three primary systemic changes associated with the acute inflammatory response are fever, leukocytosis (a transient increase in circulating leukocytes), and increased levels in circulating plasma proteins. Exudate, redness, heat, pain, and edema are local signs.
What occurs during tissue repair after damage has occured?
Non-functioning scar tissue replaces the original destroyed tissue
-Repair is the replacement of destroyed tissue with scar tissue. Regeneration is the replacement of damaged tissue with healthy tissue with complete return to normal structure and function. Resolution is synonymous with regeneration. Epithelialization is the process by which epithelial cells grow into the wound from surrounding healthy tissue.
Which chemical mediator or medatorss induce pain during an inflammatory response?
Bradykinin and prostaglandins
-The only chemical mediators that induce pain during an inflammatory response are the prostaglandins and bradykinin. Leukotrienes produce smooth muscle contraction, increased vascular permeability, and perhaps neutrophil and eosinophil chemotaxis. Histamine is released and may cause itch; it only relates to pain indirectly in that it may increase swelling. Chemotactic factors draw cells to the area but do not cause pain directly.
What is the result of phagocytosis in response to microorganisms?
Ingestion and destruction of the microorganism
-Phagocytosis is the process of the phagocyte recognizing and adhering to bacteria (opsonization), engulfing them, and destroying them.
Which of the following exudates would most concern the nurse monitoring a substantial size surgical wound at 2 days post-operative?
purulent or suppurative
-a purulent exudate could indicate infection, as it is comprised of pus and sometimes microorganisms
Keloid formation is an important part of the latter stages of wound healing. True or False?
A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest?
The patient should use a first-generation nonsteroidal anti-inflammatory medication instead.
Which of the following past medical history from a patient would be least concerning in regard to aspirin use?
a. Bleeding disorders
b. Gastric ulcers
c. Diabetes mellitus
-there is no increased risk for diabetics to take aspirin
A nurse is discussing glucocorticoids with a group of nursing students. Which statement by a student indicates understanding of the teaching?
Glucocorticoids are produced naturally by the body but have phamacologic effects at higher doses.
-endogenous glucocorticoids are produced in the body but do not have the powerful anti-inflammatory effects seen at pharmacologic doses.
Which of the following factors should the nurse keep in mind if administering Prednisone or other glucocorticoid?
Patients who have been on the drug for several months should taper rather than stop suddenly
Which of the following is a pathway for glucocorticoids to minimize inflammation (SELECT ALL THAT APPLY)
a. Suppress WBC production
b. Inhibit synthesis of chemical mediators
c. Reduce capillary wall permeability
d. Inhibit macrophage activity
Glucocorticoids have all these actions to oppose inflammation
Use of steroids in pharmacologic doses can suppress natural production of these hormones. True or false?
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