Nokea
A client who is receiving a b blocker tells the nurse that he also takes ibuprofen for arthritis pain. The nurse would be alert for which of the following?
- A. Decreased effect of the b blocker
- B. Increased risk of bradycardia
- C. Increased risk of paradoxical hypertensive effect
- D. Increase risk of hypotension
Correct Answer: A
Rationale: The nurse should monitor for the decreased effect of the b blocker in the client who is receiving a b blocker along with NSAIDs. The nurse need not monitor for increased risk of bradycardia and paradoxical hypertensive effect or decreased risk of hypotension. There is an increase in the risk of paradoxical hypertensive effect when a b-adrenergic blocking drug is administered with clonidine. There is an increase in the risk of bradycardia when a b-adrenergic blocking drug is administered with antidepressants. There is an increased risk of hypotension when a b-adrenergic blocking drug is administered with loop diuretics.
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A nurse would administer phentolamine to a client diagnosed with which condition?
- A. Pheochromocytoma-induced hypertension
- B. Benign hypertension
- C. Preoperative hypertension
- D. Increased intraocular pressure
- E. Treatment of dopamine extravasation tissue damage
Correct Answer: A,C,E
Rationale: Phentolamine is an a-adrenergic blocker used in the treatment of pheochromocytoma-induced hypertension and preoperative hypertension and in the prevention and treatment of tissue damage caused by extravasation of dopamine.
A nurse is caring for a client who has been prescribed propranolol for angina. After administering the drug, which of the following would the nurse do?
- A. Ask about relief of symptoms and record responses on the chart
- B. Determine signs of infection in the client
- C. Monitor for sudden decrease in urine output
- D. Monitor for sudden increase in intraocular pressure
Correct Answer: A
Rationale: The nurse should ask about the relief of symptoms and record the responses on the client's chart. Determining the signs of infection in the client is part of the nurse's preadministration assessment, not the ongoing assessment. The nurse need not monitor the client for a sudden decrease in urine output and a sudden increase in intraocular pressure for a client receiving propranolol therapy for angina.
A nurse is preparing to administer a centrally acting adrenergic blocker to a group of clients. The nurse would be especially cautious when administering the drug to which client?
- A. Client with diabetes
- B. Client with chronic bronchitis
- C. Client with renal function impairment
- D. Client with impaired hepatic function
Correct Answer: C
Rationale: The nurse should administer centrally acting adrenergic blockers cautiously to clients with renal function impairment. The a/b-adrenergic blocking drugs should be used cautiously in clients with diabetes, chronic bronchitis, and impaired hepatic function.
Which of the following adverse reactions would the nurse include in the teaching plan for a client who is prescribed labetalol?
- A. Hypoglycemia
- B. Insomnia
- C. Drowsiness
- D. Tachycardia
- E. Fatigue
Correct Answer: B,C,E
Rationale: Adverse effects from the use of a/b-adrenergic blockers like labetalol include fatigue, dizziness, hypotension, drowsiness, insomnia, weakness, diarrhea, dyspnea, chest pain, bradycardia, and skin rash.
A client is receiving nadolol as part of the treatment plan for hypertension. The client reports dizziness on standing. The nurse checks the client's blood pressure lying, sitting, and standing and notes a significant drop in the readings. When developing this client's plan of care, which nursing diagnosis would the nurse most likely identify?
- A. Risk for Injury
- B. Ineffective Tissue Perfusion
- C. Impaired Comfort
- D. Decreased Cardiac Output
Correct Answer: A
Rationale: The client is experiencing orthostatic hypotension, placing the client at risk for falls and injury. Ineffective Tissue Perfusion would be appropriate if the client was experiencing more rapid changes in blood pressure and/or changes in pulse and heart rate. Impaired Comfort would apply if the client was complaining of other adverse reactions such as dry mouth or constipation. There is no information provided that would suggest decreased cardiac output.