Chapter 24: Adrenergic Blocking Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A client with hypertension is prescribed clonidine. The nurse should question this order if which disorder is noted in the client's history? a. Active hepatic disease b. Active peptic ulcer c. Ulcerative colitis d. Mental depression Answer: A Rationale: The use of a centrally acting antiadrenergic drug is contraindicated in clients with active hepatic disease. The use of a centrally acting antiadrenergic drug is not contraindicated in clients with active peptic ulcer or ulcerative colitis. In clients with active peptic ulcer, ulcerative colitis, or mental depression, the use of peripherally acting antiadrenergic drug is contraindicated. It is also contraindicated if the client is using MAOIs. Question Format: Multiple Choice Chapter: 24 Learning Objective: 2 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 297, Centrally and Peripherally Acting Antiadrenergic Drugs 2. A client with a cardiac problem is treated with beta-adrenergic blocking drugs. Which reaction should the nurse point out as a generalized reaction that impacts the body when a beta-adrenergic blocking drug is given to the client? a. Vomiting b. Hyperglycemia c. Nausea d. Vertigo Answer: D Rationale: The nurse should identify vertigo as the generalized reaction that impacts the body when a beta-adrenergic blocking drug is given to the client. Vomiting, nausea, and hyperglycemia are not generalized reactions; they are gastrointestinal reactions that are observed when the client is administered beta-adrenergic blocking drugs. Question Format: Multiple Choice Chapter: 24 Learning Objective: 2 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 295, Beta-Adrenergic Blocking Drugs 3. A client who is receiving a beta blocker tells the nurse about also taking ibuprofen for arthritis pain. The nurse would be alert for which reaction? a. Decreased effect of the beta blocker b. Increased risk of bradycardia c. Increased risk of paradoxical hypertensive effect d. Increase risk of hypotension Answer: A Rationale: The nurse should monitor for the decreased effect of the beta blocker in the client who is receiving a beta blocker along with NSAIDs. The nurse does not need to monitor for increased risk of bradycardia and paradoxical hypertensive effect or decreased risk of hypotension. There is an increase in the risk of paradoxical hypertensive effect when a beta-adrenergic blocking drug is administered with clonidine. There is an increase in the risk of bradycardia when a beta-adrenergic blocking drug is administered with antidepressants. There is an increased risk of hypotension when a beta-adrenergic blocking drug is administered with loop diuretics. Question Format: Multiple Choice Chapter: 24 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 295, Beta-Adrenergic Blocking Drugs 4. A nurse is caring for a client who has been prescribed propranolol for angina. After administering the drug, which action would the nurse do? a. Ask about relief of symptoms and record responses on the chart. b. Determine signs of infection in the client. c. Monitor for sudden decrease in urine output. d. Monitor for sudden increase in intraocular pressure. Answer: A Rationale: The nurse should ask about the relief of symptoms and record the responses on the client's chart. Determining the signs of infection in the client is part of the nurse's preadministration assessment, not the ongoing assessment. The nurse does not need to monitor the client for a sudden decrease in urine output and a sudden increase in intraocular pressure for a client receiving propranolol therapy for angina. Question Format: Multiple Choice Chapter: 24 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 299, Ongoing Assessment 5. A nurse is preparing to administer propranolol to a client for the treatment of cardiac arrhythmias. The nurse checks the client's apical pulse rate and blood pressure before administration and notes that the pulse rate is 58 bpm. Which action would the nurse prioritize? a. Provide proper ventilation to the client. b. Delay drug administration for some time. c. Withhold the drug and contact health care provider. d. Immediately give oxygen via face mask.