NSG 251 – Exam 5 Study Tool Module
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9 and 10
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Autonomic Nervous System Medications (Module 9) p p p p p
Chapter 18: Adrenergic
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• Summarize client conditions that can be treated with adrenergic medications.
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Cardiac arrest, shock, allergic reactions, asthma
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• What is a contraindication to the use of adrenergic medications?
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Known allergy, severe hypertension
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• Overdose of adrenergic agonists can lead to which potentially life-threatening conditions? How can
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they be treated?
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From excessive CNS stimulation: seizures, intracranial bleeding, can be treated with
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rapid-acting sympatholytic drug
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o Epinephrine
▪ What client conditions would indicate use of epinephrine?
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Asthma, anaphylactic shock p p p
▪ What therapeutic benefits would occur with administration?
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Used in emergency situations, primary vasoactive drugs used in ACLS
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• Basic understanding of how it works. p p p p p
o Stimulates the sympathetic nervous system p p p p
• Adverse effects p
o Headache, restlessness, insomnia, euphoria, chest pain, p p p p p
vasoconstriction, hypertension, dysrhythmias, palpitations, anorexia dryp p p p p p
mouth, N/V, taste changes (alpha) p p p p p
o Mild tremors, headache, nervousness, dizziness, increased heart rate, p p p p p p p
palpitations, fluctuation in BP, sweating, N/V (beta) p p p p p p p
• Important interactions p
o Adrenergic antagonists, anesthetic drugs, MAOIs, antihistamines, p p p p p
thyroid preparations p p
•
Nursing Process (What are you going to assess, planning, implementation p p p p p p p p p
(education), evaluation (monitoring for therapeutic effects) p p p p p
o Assess cardiac thoroughly (before and after), assess respiratory p p p p p p p
(before/after), follow guidelines, avoid OTC, get baseline vitals and p p p p p p p p p
essentials p
o Norepinephrine(levophed)
▪ What client conditions would indicate use of norepinephrine?
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Hypotension and shock p p p
▪ What therapeutic benefits would occur with administration?
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Stimulates the alpha-adrenergic receptors leading to vasoconstriction
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▪ This medication is administered via IV infusion. What are the responsibilities of a nurse?
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, Infuse slowly p
• Adverse effects p
o Headache, restlessness, insomnia, euphoria, chest pain, p p p p p
vasoconstriction, hypertension, dysrhythmias, palpitations, anorexia,
p p p p p
dry mouth, N/V, taste changes p p p p p
• Important interactions p
o Adrenergic antagonists, anesthetic drugs, MAOIs, antihistamines, p p p p p
thyroid preparations p p
•
Nursing Process (What are you going to assess, planning, implementation p p p p p p p p p
(education), evaluation (monitoring for therapeutic effects) p p p p p
o Assess cardiac thoroughly (before and after), assess respiratory p p p p p p p
(before/after), follow guidelines, avoid OTC, get baseline vitals and p p p p p p p p p
essentials p
Chapter 19: Adrenergic Blockers
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• Summarize client conditions that can be treated with adrenergic blockers.
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Prevent/control hypertension in patients with pheochromocytoma, benign prostatic p p p p p p p
hyperplasia, Raynaud’s disease, acrocyanosis, and frostbite
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• What would be contraindications to use of adrenergic blockers?
p p p p p p p p
Known allergies, peripheral vascular disease, hepatic/renal disease, coronary artery
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disease, peptic ulcer, sepsis
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• What are common adverse effects?
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Palpitations, orthostatic hypotension, tachycardia, N/V, diarrhea, constipation, dizziness
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• How can an overdose of alpha blockers be treated?
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Overdose = hypotension(IV fluids and vasopressors) and seizures(diazepam(Valium) or
p p p p p p p p
lorazepam(Ativan)) p
• What teaching should be provided to clients taking adrenergic blockers?
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Change positions slows, always check heart rate and blood pressure before and after
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administration, do NOT abruptly stop wean off
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• What assessments should be completed prior to administering an adrenergic blocker?
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Assess heart rate and blood pressure p p p p p
• Alpha 1 Blockers p p
o Phentolamine(Regitine)
▪ What client conditions would indicate use of phentolamine?
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Mild-moderate hypertension, also used for extraversion of vasoconstricting p p p p p p p
drugs(norepinephrine, epinephrine, and dopamine) restore blood flow and prevent
p p p p p p p p p p
tissue necrosis, also used to diagnose pheochromocytoma
p p p p p p p
▪ What potentially life-threatening conditions can be caused by overdose? How can this be
p p p p p p p p p p p p
treated? p
Severe hypotension(IV fluids and vasopressors) and seizures(diazepam(valium) or
p p p p p p p
lorazepam(Ativan) p
o Basic understanding of how it works. p p p p p
o Inhibits sympathetic nervous system responses p p p p
o Adverse effects p
, o
Palpitations, orthostatic hypotension, tachycardia, N/V, diarrhea, constipation,
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dizziness p
o Important interactions/contraindications
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o Hypersensitivity, myocardial infarction, and coronary artery disease p p p p p p
o Nursing Process (What are you going to assess, planning, implementation (education),
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evaluation (monitoring for therapeutic effects)
p p p p p
o Assess heart rate and blood pressure before administration, do not abruptly
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stop p
o Tamsulosin(Flomax)
▪ What is tamsulosin primarily used for?
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Benign prostatic hyperplasia(male), occasionally used for female patients with kidney
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stones
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▪ What other drug cannot be used with this medication?
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Erectile dysfunction drugs(sildenafil)
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o Basic understanding of how it works.
p p p p p
o Inhibits sympathetic nervous system responses p p p p
o Adverse effects p
o Headache, abnormal ejaculation, rhinitis p p p
o Nursing Process (What are you going to assess, planning, implementation (education),
p p p p p p p p p p
evaluation (monitoring for therapeutic effects)
p p p p p
o Assess heart rate and blood pressure before administration, do not abruptly
p p p p p p p p p p
stop p
• Beta Blockers
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o Covered in module 7 (Review if needed) Know as a classification. Remember ends in “lol”
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o Basic understanding of how it works.
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o Inhibits sympathetic nervous system responses p p p p
o Beta1 heart p p
o Beta2 heart and lungs p p p p
o Uses (what does it treat)
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o Angina, cardioprotective after MI, dysrhythmias, migraine headaches,
p p p p p p
antihypertensive, HF, glaucoma(topical)
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o Adverse effects p
o Agranulocytosis, thrombocytopenia, AV block, bradycardia, HF, dizziness, p p p p p p
depression, unusual dreams, drowsiness, N/V, diarrhea, constipation,
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impotence, alopecia, wheezing, bronchospasm, dry mouth, delayed
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hypoglycemia recovery, masked symptoms of hypoglycemia, hyperlipidemia
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o Important interactions/contraindications
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o Known allergy, uncompensated HF, cardiogenic shock, heart block, bradycardia,
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pregnancy, severe pulmonary disease, Raynaud’s disease
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o Nursing Process (What are you going to assess, planning, implementation (education),
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pevaluation (monitoring for therapeutic effects)
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p p p p p p p
9 and 10
p p p
Autonomic Nervous System Medications (Module 9) p p p p p
Chapter 18: Adrenergic
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• Summarize client conditions that can be treated with adrenergic medications.
p p p p p p p p p
Cardiac arrest, shock, allergic reactions, asthma
p p p p p p
• What is a contraindication to the use of adrenergic medications?
p p p p p p p p p
Known allergy, severe hypertension
p p p p
• Overdose of adrenergic agonists can lead to which potentially life-threatening conditions? How can
p p p p p p p p p p p p
they be treated?
p p p
From excessive CNS stimulation: seizures, intracranial bleeding, can be treated with
p p p p p p p p p p
rapid-acting sympatholytic drug
p p p
o Epinephrine
▪ What client conditions would indicate use of epinephrine?
p p p p p p p
Asthma, anaphylactic shock p p p
▪ What therapeutic benefits would occur with administration?
p p p p p p
Used in emergency situations, primary vasoactive drugs used in ACLS
p p p p p p p p p
• Basic understanding of how it works. p p p p p
o Stimulates the sympathetic nervous system p p p p
• Adverse effects p
o Headache, restlessness, insomnia, euphoria, chest pain, p p p p p
vasoconstriction, hypertension, dysrhythmias, palpitations, anorexia dryp p p p p p
mouth, N/V, taste changes (alpha) p p p p p
o Mild tremors, headache, nervousness, dizziness, increased heart rate, p p p p p p p
palpitations, fluctuation in BP, sweating, N/V (beta) p p p p p p p
• Important interactions p
o Adrenergic antagonists, anesthetic drugs, MAOIs, antihistamines, p p p p p
thyroid preparations p p
•
Nursing Process (What are you going to assess, planning, implementation p p p p p p p p p
(education), evaluation (monitoring for therapeutic effects) p p p p p
o Assess cardiac thoroughly (before and after), assess respiratory p p p p p p p
(before/after), follow guidelines, avoid OTC, get baseline vitals and p p p p p p p p p
essentials p
o Norepinephrine(levophed)
▪ What client conditions would indicate use of norepinephrine?
p p p p p p p
Hypotension and shock p p p
▪ What therapeutic benefits would occur with administration?
p p p p p p
Stimulates the alpha-adrenergic receptors leading to vasoconstriction
p p p p p p
▪ This medication is administered via IV infusion. What are the responsibilities of a nurse?
p p p p p p p p p p p p p
, Infuse slowly p
• Adverse effects p
o Headache, restlessness, insomnia, euphoria, chest pain, p p p p p
vasoconstriction, hypertension, dysrhythmias, palpitations, anorexia,
p p p p p
dry mouth, N/V, taste changes p p p p p
• Important interactions p
o Adrenergic antagonists, anesthetic drugs, MAOIs, antihistamines, p p p p p
thyroid preparations p p
•
Nursing Process (What are you going to assess, planning, implementation p p p p p p p p p
(education), evaluation (monitoring for therapeutic effects) p p p p p
o Assess cardiac thoroughly (before and after), assess respiratory p p p p p p p
(before/after), follow guidelines, avoid OTC, get baseline vitals and p p p p p p p p p
essentials p
Chapter 19: Adrenergic Blockers
p p p
• Summarize client conditions that can be treated with adrenergic blockers.
p p p p p p p p p
Prevent/control hypertension in patients with pheochromocytoma, benign prostatic p p p p p p p
hyperplasia, Raynaud’s disease, acrocyanosis, and frostbite
p p p p p p
• What would be contraindications to use of adrenergic blockers?
p p p p p p p p
Known allergies, peripheral vascular disease, hepatic/renal disease, coronary artery
p p p p p p p p
disease, peptic ulcer, sepsis
p p p p
• What are common adverse effects?
p p p p
Palpitations, orthostatic hypotension, tachycardia, N/V, diarrhea, constipation, dizziness
p p p p p p p
• How can an overdose of alpha blockers be treated?
p p p p p p p p
Overdose = hypotension(IV fluids and vasopressors) and seizures(diazepam(Valium) or
p p p p p p p p
lorazepam(Ativan)) p
• What teaching should be provided to clients taking adrenergic blockers?
p p p p p p p p p
Change positions slows, always check heart rate and blood pressure before and after
p p p p p p p p p p p p
administration, do NOT abruptly stop wean off
p p p p p p p p
• What assessments should be completed prior to administering an adrenergic blocker?
p p p p p p p p p p
Assess heart rate and blood pressure p p p p p
• Alpha 1 Blockers p p
o Phentolamine(Regitine)
▪ What client conditions would indicate use of phentolamine?
p p p p p p p
Mild-moderate hypertension, also used for extraversion of vasoconstricting p p p p p p p
drugs(norepinephrine, epinephrine, and dopamine) restore blood flow and prevent
p p p p p p p p p p
tissue necrosis, also used to diagnose pheochromocytoma
p p p p p p p
▪ What potentially life-threatening conditions can be caused by overdose? How can this be
p p p p p p p p p p p p
treated? p
Severe hypotension(IV fluids and vasopressors) and seizures(diazepam(valium) or
p p p p p p p
lorazepam(Ativan) p
o Basic understanding of how it works. p p p p p
o Inhibits sympathetic nervous system responses p p p p
o Adverse effects p
, o
Palpitations, orthostatic hypotension, tachycardia, N/V, diarrhea, constipation,
p p p p p p
dizziness p
o Important interactions/contraindications
p
o Hypersensitivity, myocardial infarction, and coronary artery disease p p p p p p
o Nursing Process (What are you going to assess, planning, implementation (education),
p p p p p p p p p p
evaluation (monitoring for therapeutic effects)
p p p p p
o Assess heart rate and blood pressure before administration, do not abruptly
p p p p p p p p p p
stop p
o Tamsulosin(Flomax)
▪ What is tamsulosin primarily used for?
p p p p p
Benign prostatic hyperplasia(male), occasionally used for female patients with kidney
p p p p p p p p p
stones
p
▪ What other drug cannot be used with this medication?
p p p p p p p p
Erectile dysfunction drugs(sildenafil)
p p
o Basic understanding of how it works.
p p p p p
o Inhibits sympathetic nervous system responses p p p p
o Adverse effects p
o Headache, abnormal ejaculation, rhinitis p p p
o Nursing Process (What are you going to assess, planning, implementation (education),
p p p p p p p p p p
evaluation (monitoring for therapeutic effects)
p p p p p
o Assess heart rate and blood pressure before administration, do not abruptly
p p p p p p p p p p
stop p
• Beta Blockers
p
o Covered in module 7 (Review if needed) Know as a classification. Remember ends in “lol”
p p p p p p p p p p p p p p
o Basic understanding of how it works.
p p p p p
o Inhibits sympathetic nervous system responses p p p p
o Beta1 heart p p
o Beta2 heart and lungs p p p p
o Uses (what does it treat)
p p p p
o Angina, cardioprotective after MI, dysrhythmias, migraine headaches,
p p p p p p
antihypertensive, HF, glaucoma(topical)
p p p
o Adverse effects p
o Agranulocytosis, thrombocytopenia, AV block, bradycardia, HF, dizziness, p p p p p p
depression, unusual dreams, drowsiness, N/V, diarrhea, constipation,
p p p p p p p
impotence, alopecia, wheezing, bronchospasm, dry mouth, delayed
p p p p p p p
hypoglycemia recovery, masked symptoms of hypoglycemia, hyperlipidemia
p p p p p p p
o Important interactions/contraindications
p
o Known allergy, uncompensated HF, cardiogenic shock, heart block, bradycardia,
p p p p p p p p
pregnancy, severe pulmonary disease, Raynaud’s disease
p p p p p p
o Nursing Process (What are you going to assess, planning, implementation (education),
p p p p p p p p p p
pevaluation (monitoring for therapeutic effects)
p p p p
