Nokea
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.
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When caring for a client who is receiving acebutolol (Sectral), the nurse would ensure that which of the following is avoided to promote optimal effectiveness of acebutolol?
- A. Sertraline (Zoloft)
- B. Phenelzine (Nardil)
- C. Naproxen (Naprosyn)
- D. Oxaprezin (Daypro)
- E. Fluoxetine (Prozac)
Correct Answer: C,D
Rationale: NSAIDs (naproxen and oxaprozin) can result in decreased effects of b blockers such as acebutolol.
A nurse would administer phentolamine cautiously to a client with which condition?
- A. Recent MI
- B. Type 1 diabetes
- C. Renal failure
- D. Hepatic failure
- E. Peripheral artery disease
Correct Answer: A,C
Rationale: Phentolamine is an a-adrenergic blocker that should be used cautiously in clients who are pregnant or lactating, had a recent MI, or have renal failure or Reynaud's disease.
A nurse is caring for a client with an arrhythmia. Which of the following would be most important for the nurse to do for a client with a life-threatening arrhythmia who is receiving an adrenergic blocking drug intravenously?
- A. Perform continuous cardiac monitoring
- B. Obtain pulse rate readings every 6 to 8 hours
- C. Assess respiratory rate every hour
- D. Obtain body temperature readings every 15 minutes
Correct Answer: A
Rationale: The patient with a life-threatening arrhythmia may receive an adrenergic blocking drug, such as propranolol, by the intravenous (IV) route. When these drugs are administered IV, cardiac monitoring is necessary. Patients not in a monitored unit are usually transferred to one as soon as possible. When these drugs are administered for a life-threatening arrhythmia, it is important to monitor the patient continuously with cardiac, blood pressure, and respiratory rate monitoring frequently.
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 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.