Nokea
A nurse is preparing to administer propranolol to a client for the treatment of cardiac arrhythmias. The nurse checks the client's apical pulse rate and blood pressure before administration and notes that the pulse rate is below 60 bpm. Which of the following would the nurse do next?
- A. Provide proper ventilation to the client
- B. Delay drug administration for some time
- C. Withhold the drug and contact the primary health care provider
- D. Immediately give oxygen via face mask
Correct Answer: C
Rationale: The nurse should withhold the drug and contact the primary health care provider if the pulse rate of the client is below 60 bpm. Providing proper ventilation to the client, delaying drug administration for some time, or providing oxygen support to the client would be inappropriate for this client.
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A client with cardiac arrhythmia is treated with a centrally acting antiadrenergic drug. The nurse would assess the client for which of the following as a possible adverse reaction?
- A. Lightheadedness
- B. Malaise
- C. Bradycardia
- D. Weakness
Correct Answer: B
Rationale: The nurse should monitor the client for malaise as a generalized reaction with antiadrenergic drugs that are centrally acting when administered to clients with cardiac arrhythmias. Lightheadedness, bradycardia, and weakness are the adverse reactions associated with peripherally acting antiadrenergic drugs.
A nurse would closely monitor which client for an increase in possible adverse reactions after administering propranolol?
- A. Clients with asthma
- B. Clients with hyperlipidemia
- C. Clients with diabetes
- D. Clients with peptic ulcer disease
- E. Clients with migraine headaches
Correct Answer: A,C,D
Rationale: A nurse should carefully observe clients with asthma (bronchospasm can result with the use of nonselective b blockers) and diabetes (b blockers can mask the symptoms of hypoglycemia) during the use of propranolol (Inderal), a nonselective b blocker. The drug also should be used cautiously in clients with peptic ulcer disease.
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 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).
A nurse recognizes the class of medication being administered to help plan ongoing assessment and client education. The nurse would identify which drug as an example of a b-adrenergic blocker?
- A. Carvedilol (Coreg)
- B. Propranolol (Inderal)
- C. Metoprolol (Lopressor)
- D. Atenolol (Tenormin)
- E. Labetalol (Trandate)
Correct Answer: B,C,D
Rationale: Propranolol, metoprolol, and atenolol are b-adrenergic blockers, but carvedilol and labetalol are a/b-adrenergic blockers.