Nokea
A nurse is conducting discharge teaching with a client being discharged on clonidine (Catapres). The nurse would instruct the client about which of the following as a possible adverse reaction?
- A. Dry mouth
- B. Bradycardia
- C. Sedation
- D. Anorexia
- E. Tachypnea
Correct Answer: A,C,D
Rationale: Adverse reactions associated with the use of centrally acting antiadrenergic drugs like clonidine (Catapres) include dry mouth, drowsiness, sedation, anorexia, rash, malaise, and weakness.
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A group of nursing students are reviewing information about adrenergic blockers in preparation for an examination. The students demonstrate understanding of the information when they identify which of the following as an a/b-adrenergic blocker?
- A. Phentolamine
- B. Bisoprolol
- C. Nadolol
- D. Carvedilol
- E. Labetalol
Correct Answer: D,E
Rationale: Carvedilol and labetalol are a/b-adrenergic blockers. Phentolamine is an a-adrenergic blocker. Bisoprolol and nadolol are b-adrenergic blockers.
A nurse is reviewing the medication orders for a client and notes an adrenergic blocker that is to be applied transdermally. Which medication would the nurse be preparing to administer?
- A. Methyldopa
- B. Clonidine
- C. Guanabenz
- D. Guanfacine
Correct Answer: B
Rationale: Clonidine is available in a transdermal formulation. Methyldopa may be administered IV or orally. Guanabenz and guanfacine are administered orally.
A nurse understands that while most b-adrenergic receptors are found in the heart, they are also commonly found in which other organs?
- A. Pancreas
- B. Eyes
- C. Liver
- D. Lungs
- E. Skin
Correct Answer: B,D
Rationale: b-adrenergic receptors are also found in the eyes and lungs. The blockage of these receptors can be beneficial in treatment of glaucoma or cause adverse reactions in the lungs (bronchospasms).
The nurse should observe elderly clients taking metoprolol (Lopressor) for which of the following adverse effects as they are more likely to occur in elderly clients?
- A. Hyperglycemia
- B. Heart failure
- C. Peripheral vascular insufficiency
- D. Confusion
- E. Worsening angina
Correct Answer: B,C,D,E
Rationale: The nurse should observe elderly clients taking metoprolol (Lopressor) for confusion, heart failure, worsening angina, shortness of breath, and peripheral vascular insufficiency.
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.