Nokea
The nurse is presenting information to a class of students about adrenergic drugs. Which are the effects of drugs that stimulate the sympathetic nervous system?
- A. Dilation of bronchioles
- B. Constriction of bronchioles
- C. Decreased heart rate
- D. Increased heart rate
- E. Dilated pupils
- F. Constricted pupils
- G. Glycogenolysis
Correct Answer: A,D,E,G
Rationale: Stimulation of the sympathetic nervous system causes bronchodilation, increased heart rate, pupil dilation, and glycogenolysis as well as many other effects. The other responses are effects that occur as a result of the stimulation of the parasympathetic nervous system.
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A patient is on a low-dose dobutamine drip for heart failure. She had been feeling better but now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her heart rate is up to 110 beats/min, and her blood pressure is 150/98 mm Hg (increased from previous readings of 86 beats/min and 120/80 mm Hg). What is the nurse's immediate concern for this patient?
- A. She is experiencing normal adverse effects of dobutamine therapy.
- B. She may be experiencing an allergic reaction to the dobutamine.
- C. The medication may be causing a worsening of a preexisting cardiac disorder.
- D. The dosage of the dobutamine needs to be increased to control the symptoms better.
Correct Answer: C
Rationale: Because dobutamine is a vasoactive adrenergic, it works by increasing the cardiac output in heart failure patients by increasing myocardial contractility and stroke volume. However, adrenergic drugs may worsen a preexisting cardiac disorder, such as causing a myocardial infarction in a patient with coronary artery disease. The other options are incorrect.
The nurse is preparing to administer dopamine. Which is the correct technique for administering dopamine?
- A. Orally
- B. Intravenous (IV) push injection
- C. Intermittent IV infusions (IV piggyback)
- D. Continuous IV infusion with an infusion pump
Correct Answer: D
Rationale: Dopamine is available only as an IV injectable drug and is given by continuous infusion, using an infusion pump. The other options are incorrect.
An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs?
- A. Volume restoration
- B. Increased cardiac output
- C. Decreased urine output
- D. Reduced anxiety
Correct Answer: B
Rationale: For a patient in shock, a primary benefit of an adrenergic agonist drug is to increase cardiac output. A drug in this category should not be used in place of volume restoration, nor does it provide volume restoration (IV fluids do this). Adrenergic agonists may enhance urine output if cardiac output and perfusion to the kidneys increase. These drugs do not reduce anxiety.
A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse expect to use to treat this condition?
- A. Ephedra
- B. Epinephrine
- C. Phenylephrine
- D. Pseudoephedrine
Correct Answer: B
Rationale: Epinephrine is the drug of choice for the treatment of anaphylaxis. The other drugs listed are incorrect choices.
When an adrenergic drug stimulates beta-adrenergic receptors, the result is an increased heart rate, which is known as what type of effect?
- A. Positive inotropic
- B. Antiadrenergic
- C. Positive chronotropic
- D. Positive dromotropic
Correct Answer: C
Rationale: A positive chronotropic effect is an increased heart rate. An increased force of contraction is known as a positive inotropic effect. Positive dromotropic effect is an increase in the conduction of cardiac electrical nerve impulses through the atrioventricular node.