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).
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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.
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.
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 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.
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.
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