Chapter 23: Adrenergic Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford
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Course
Clinical Pharmacology
Institution
Clinical Pharmacology
Introductory Clinical Pharmacology 12th Edition by Susan M Ford
1. An older client with acute sinusitis is administered epinephrine emergently. The nurse should prioritize reporting a change in which assessment finding to the health care provider?
a. Blood glucose level
b. Appetite
c. Temp...
Chapter 23: Adrenergic Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford
1.An older client with acute sinusitis is administered epinephrine emergently. The nurse should prioritize reporting a change in which assessment finding to the health care provider? a.Blood glucose level b.Appetite c.Temperature d.Pulse rate Answer: D Rationale: The nurse should report any changes observed in pulse rate or rhythm immediately. Epinephrine does not affect the glucose level, appetite, or temperature. These do not need to be reported immediately to the primary care provider unless they are severe. The nurse would need to perform further assessments to determine the cause of these findings. Question Format: Multiple Choice Chapter: 23 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 286, Lifespan Considerations 2.The nurse is preparing to teach a client with intractable orthostatic hypotension about the midodrine which has been prescribed. Which instruction will the nurse prioritize in the teaching? a.Take midodrine during the day while awake. b.Remain in a supine position for 30 minutes. c.Take the medication at bedtime. d.Instruct on the use of assistive devices. Answer: A Rationale: The nurse can minimize the risk of supine hypertension by instructing that the drug should be taken during the daytime and not at bedtime. The nurse should ensure that the client stays in an upright, not supine, position. The use of assistive devices depends on the condition of the client and may or may not be related to the use of midodrine. The main concern is preventing supine hypertension. Question Format: Multiple Choice Chapter: 23 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 286, Contraindications 3.A client presents to the emergency department following a traffic accident. The nurse prepares to administer an adrenergic agent after assessing for signs of shock which includes which finding? a.Increased temperature b.Reddish/pinkish skin c.Dry, dehydrated skin d.Changes in consciousness Answer: D Rationale: Symptoms of shock, such as a change in the level of consciousness, should be recorded by the nurse as part of the preadministration assessment. Cool skin, not elevated temperature, is another symptom of shock. The nurse also needs to record signs of diaphoresis and cyanosis, not reddish/pinkish or dry, dehydrated skin. Question Format: Multiple Choice Chapter: 23 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 287, Preadministration Assessment 4.A client is prescribed dopamine. Which point would the nurse include in the client's plan of care? a.Administering dopamine only via IV route b.Maintaining a fixed rate of administration c.Monitoring blood pressure every half hour d.Diluting dopamine with sodium bicarbonate Answer: A Rationale: The nurse should ensure that dopamine is administered intravenously. The rate of administration of the drug should be adjusted according to the client's blood pressure, and it should not be fixed at any particular rate. The client should be monitored continuously from the beginning of therapy until the desired blood pressure is achieved. Dopamine is not mixed with sodium bicarbonate or any other alkaline IV solutions. It should also not be diluted as it will change the amount of drug being infused and may not achieve the
desired results. Question Format: Multiple Choice Chapter: 23 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 287, Ineffective Tissue Perfusion 5.A nurse is monitoring a client receiving IV dobutamine. Which assessment finding should the nurse prioritize? a.Cardiac arrhythmias b.Urinary retention c.Elevated temperature d.Sleeplessness Answer: A Rationale: The nurse should monitor for cardiac arrhythmias (bradycardia and tachycardia) because they are common adverse reactions observed in clients receiving dobutamine. Dobutamine does not cause urinary retention, elevated temperature, or sleeplessness. Droxidopa can cause urinary retention. Sulfonamides may cause elevated temperatures. Cholinesterase inhibitors may cause sleeplessness. Question Format: Multiple Choice Chapter: 23 Learning Objective: 3
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