Nokea
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.
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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 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 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.
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.