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The nurse is educating a client about a spinal cord injury. Which statement by the client indicates the need for further teaching regarding the effect the injury will have on the autonomic nervous system?
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I wont be able to feed myself
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The nurse is preparing to administer adrenergic agonists to several clients on a neurological unit. Which medication can be administered by mouth?
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The nurse is checking a client's blood pressure in preparation for administering an adrenergic antagonist medication. Which systolic blood pressure is unsafe for administering this class of medication?
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The nurse is educating a client on the effects that adrenergic antagonists have on the body. Which statement by the client indicates appropriate understanding of the teaching provided?
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My medication will decrease my heart rate
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The nurse is teaching a group of clients with asthma about the ways in which adrenergic agonists stimulate the sympathetic nervous system. Which clinical effect is evidence of this type of stimulation?
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The nurse is caring for a client with Raynaud's syndrome who has been prescribed adrenergic antagonist therapy. Which effect of this medication will alleviate the client's symptoms?
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Decreased vasospasms
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The nurse is caring for a client who is taking an adrenergic agonist. Which cardiopulmonary system effects should the nurse expect this medication to produce?
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The nurse is preparing to administer a metered-dose inhaler to a client with asthma. How long should the nurse instruct the client to wait before administering a second dose?
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At least 2 minutes
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The following steps describe how a message is transmitted from one neuron to another
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When an action is required within the body, an impulse—called an action potential—is initiated by the CNS.In order for the action potential to transmit, it must get across the synaptic cleft, the physical space between two neurons.When the action potential reaches the synaptic cleft, neurotransmitters are released from vesicles in the presynaptic neuron.Neurotransmitters cross the synaptic cleft through the mechanism of diffusion. They bind with receptors in the postsynaptic neuron to elicit the needed response.The neurotransmitters are then either broken down or returned to the presynaptic neuron, where they wait to respond again when needed.
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Medications may also affect synaptic transmission by
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Increasing or decreasing neurotransmitter synthesisInhibiting the storage of neurotransmitters in synaptic vesiclesIncreasing or decreasing the release of neurotransmittersBinding to the postganglionic cells to stimulate or inhibit the autonomic nervous system responsePreventing the breakdown or reuptake of neurotransmitters after the action potential is conveyed, causing the autonomic response to continue
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Adrenergic agonists
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also called sympathomimetics, stimulate the sympathetic nervous system.
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Adrenergic antagonists
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also called adrenergic blockers, inhibit the sympathetic nervous system.
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Vasoconstriction of vascular smooth muscle
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Peripheral vasodilation
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Increased heart rateincreased strength of cardiac contractionDilation of the coronary arteriesRelease of renin by the kidneys
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Vasodilation that causes:Dilation of the bronchiolesDecreased peristalsisDecreased urine production
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Norepinephrine (NE)
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neurotransmitter and neurohormone of the SNS; also a hormone secreted by the adrenal gland
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Hormone released by the adrenal gland also know as adrenaline
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neurotransmitter and neurohormone
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Sympathomimetic drugs work in one of two ways:
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Bind at an adrenergic receptor site, thereby stimulating an autonomic responseIncrease the amount of NE in the synaptic cleft by:Stimulating the release of NE from neuron storage vesiclesInhibiting the reuptake of NE back into neuron storage vesiclesInhibiting the enzyme breakdown of NE in the synaptic cleft
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dopamine, epinephrine, isoproterenol, NE
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Noncatecholamines
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ephedrine, phenylephrine, terbutaline
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Which division of the nervous system is responsible for voluntary control of skeletal muscles?
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Somatic nervous system
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Arrange the steps that describe how a message is transmitted from one neuron to another.
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An action potential is initiated by the CNS. , The action potential reaches the synaptic cleft. , Neurotransmitters are released from vesicles in the presynaptic neuron. , Neurotransmitters cross the synaptic cleft and bind with receptors in the postsynaptic neuron. , Neurotransmitters are either broken down or returned to the presynaptic neuron.
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Which statements accurately describe the mechanisms of action of adrenergic drugs?
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Adrenergic antagonists inhibit the SNS.Adrenergic agonists stimulate the SNS
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Which endogenous substance is also known as adrenaline?
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Classify adrenergic agonist based on their characteristics
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Catecholamines *EpinephrineNoncatecholamines *Oral administrationCatecholamines *DopamineNoncatecholamines * easily destroyed by MAO or COMTCatecholamines *Not able to cross blood-brain barrierNoncatecholamines *PhenylephrineCatecholamines *NorepinephrineNoncatecholamines *Able to cross blood-brain barrierCatecholamines *Not given in oral formNoncatecholamines *EphedrineCatecholamines *Short duration of actionNoncatecholamines *Longer duration of actionCatecholamines *IsoproterenolNoncatecholamines *TerbutalineCatecholamines *Easily destroyed by MAO or COMt
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Identify the drug based on its primary therapeutic use or effect
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Relieves Congestion ,-Xylometaoline (Otrivin) Treats Bronchospasms ,Levalbuterol(Xopenex) Treats Cardiogenic Shock , DopamineRelieves Congestion *Oxymetazoline (afrin) Treats Bronchospasms*Salmeterol(serevent) Treats Cardiogenic Shock*Norepinephrine(leverterenol)Relieves Congestion*Pseudoephedrine(Sudafed), Treats Bronchospasms*formoterol(perforomist) Relieves Congestion*tetrahydrozoline(tyzine) Treats Bronchospasms*pirbuterol(maxair) Relieves Congestion*Phenylephrine (sinex) Treats Bronchospasms* terbutaline Relieves Congestion*Naphazoline (naphcon)
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Which effects are associated with various adrenergic antagonists?
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Decreased heart rateIncreased urinationIncreased lacrimation
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Identify the adrenergic antagonist category based on the drug
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Atenolol (Tenormin)* Selective Beta 1-Adrenergic AntagonistsTerazosin (Hytrin)*Alpha adrenergic antagonistsNadolol (Corgard)*Nonselective Beta-Adrenergic blockersNebivolol (bystolic) *Selective Beta 1-Adrenergic AntagonistsTamsulosin (Flomax)*Alpha adrenergic antagonistsPindolol (Visken)*Nonselective Beta-Adrenergic blockersMetoprolol (Lopressor)*Selective Beta 1-Adrenergic AntagonistsPhenoxybenzamine (Dibenzyline)*Alpha adrenergic antagonistsSotalol (betapace)*Nonselective Beta-Adrenergic blockersBisoprolol (zebeta)*Selective Beta 1-Adrenergic AntagonistsPrazosin (Minipress)* Alpha Adrenergic AntagonistCarvedilol (coreg)*Nonselective Beta-Adrenergic blockersEsmolol (brevibloc)*Selective Beta 1-Adrenergic AntagonistsAlfuzosin (UroXatral) * Alpha=Adrenergic AntagonistTimolol (Timoptic)*Nonselective Beta-Adrenergic blockersBetaxolol (Betopic)*Selective beta 1-adrenergic antagonistsPhentolamine (Regitine)* Alpha-Adrenergic AntagonistsCarteolol (Ocupress)*Nonselective Beta-Adrenergic blockersDoxazosin (cadura)* Alpha-Adrenergic antagonistsPenbutolol (levatol)*Nonselective Beta-Adrenergic blockersAcebutolol (Sectral)*Selective Beta 1-Adrenergic AntagonistsPropranolol (Inderal)*Nonselective Beta-Adrenergic blockers
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What are possible adverse effects of various nonselective beta-adrenergic antagonists?
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Risk of hyperlipidemialoss of energy in skeletal musclesbronchospasms
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Before administering an adrenergic agonist, for what health conditions should the nurse assess in particular?
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AnginaDiabetesHypertensionHyperthyroidism
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How long should you instruct a client to wait between inhaler doses?
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During the implementation phase of administering an adrenergic antagonist, for what adverse effects should you especially monitor
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Syncopetinnitusorthostatic hypotension
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Danny Feld, a healthy young male, comes into the emergency department after being mugged near the hospital. He has sustained minor cuts and bruises, but mainly he is upset. Mr. Feld asks you why his mouth is dry, yet he is sweating. How might you, as the nurse, best reassure Mr. Feld?
answer
Explain to Mr. Feld, in simple terms, the body's natural fight-or-flight response
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Mrs. Laura Luchow is brought to the emergency department following a barbiturate overdose. What nonselective sympathomimetic could be of therapeutic use to Mrs. Luchow?
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Ephedrine hydrochloride (efedron)
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Your client, Mario Sabatini, has survived myocardial infarction. Mr. Sabatini has just been prescribed carvedilol (Coreg) for hypertension and left ventricular dysfunction. In reviewing Mr. Sabatini's medical history, you see that he also suffers from occasional bronchial asthma attacks. As his nurse, what should you do?
answer
Question the prescription of a nonselective beta adrenergic antagonist
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Your client, Jill Aquino, presents with ophthalmic congestion. Her husband brought her to the clinic, where her health care provider prescribed naphazoline (Naphcon). During client education, what do you tell Ms. Aquino to avoid?
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Driving a vehicle after administering
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The nurse is monitoring a client for adverse effects associated with the administration of an adrenergic antagonist. The nurse correctly teaches the client that which adverse effect is related to the first-dose phenomenon?
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The nurse is teaching a client how antiepileptic medications can be used to treat her seizure disorder. The nurse plans the teaching based on the knowledge that medications affect the synaptic transmission through which means?Select all that apply.Increasing or decreasing neurotransmitter synthesisEnhancing the storage of neurotransmittersIncreasing or decreasing the release of neurotransmittersStimulating or inhibiting the autonomic nervous systemPreventing the breakdown of neurotransmitters
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Increasing or decreasing neurotransmitter synthesisIncreasing or decreasing the release of neurotransmittersStimulating or inhibiting the autonomic nervous systemPreventing the breakdown of neurotransmitters
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The nurse in the neurological unit is discussing the nervous system with a colleague who was recently transferred to that unit. The nurse tells the colleague that the central nervous system communicates with the parasympathetic nervous system through which cells?
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The nurse is preparing to administer a beta-adrenergic antagonist to a client. The nurse anticipates that this medication will have which effects on the client?Select all that apply.Decreased heart rateIncreased blood pressureIncreased conduction through the AV nodeDecreased force of myocardial contractionDecrease in angina
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Decreased heart rateDecreased force of myocardial contractionDecrease in angina
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The nurse is caring for a client who developed extravasation from a dopamine drip. The nurse anticipates that the health care provider will order which medication to treat this disorder?Alfuzosin (UroXatral)Doxazosin mesylate (Cardura)Phentolamine mesylate (Regitine)Phenoxybenzamine hydrochloride (Dibenzyline)
answer
Phentolamine mesylate (Regitine)
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The nurse is teaching a group of clients about effective therapies for nasal congestion. Which alpha-adrenergic agonist medications might be useful for these clients?Select all that apply.Midodrine hydrochloride (ProAmatine)Xylometazoline hydrochloride (Otrivin)Oxymetazoline hydrochloride (Afrin)Phenylephrine hydrochloride (Sinex)Tetrahydrozoline hydrochloride (Tyzine)
answer
Xylometazoline hydrochloride (Otrivin)Oxymetazoline hydrochloride (Afrin)Phenylephrine hydrochloride (Sinex)Tetrahydrozoline hydrochloride (Tyzine)
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The nurse is preparing to educate a client who has been prescribed an adrenergic agonist inhaler. The nurse should include which instructions in the client education?Select all that apply.Sit straight up when administering the inhaler.Shake the inhaler prior to administration.Rinse the mouth with water after using the inhaler.Avoid sharing the inhaler with other family members.Monitor for rebound congestion.
answer
Sit straight up when administering the inhaler.Shake the inhaler prior to administration.Rinse the mouth with water after using the inhaler.Avoid sharing the inhaler with other family members.
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The nurse is talking to a client who has listed pseudoephedrine hydrochloride (Sudafed) as a medication taken on a daily basis. What condition is this client most likely treating with this medication?
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dopamine, epinephrine, isoproterenol, NE
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Noncatecholamines
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ephedrine, phenylephrine, terbutaline
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dopamine, epinephrine, isoproterenol, NE
question
Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
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dopamine, epinephrine, isoproterenol, NE
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Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
question
Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
question
Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
question
Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
question
Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
question
Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
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Noncatecholamines
answer
ephedrine, phenylephrine, terbutaline
answer
dopamine, epinephrine, isoproterenol, NE
