A patient is admitted to the emergency department in shock. Isoproterenol (Isuprel) is admitted. What would the nurse expect the effect of this drug would be?

Decreased blood pressure

Decreased heart rate

Increased body temperature

Increased blood pressure

Answer and Explanation

The Correct Answer is D

A) Decreased blood pressure:
Isoproterenol (Isuprel) is a non-selective beta-adrenergic agonist that primarily stimulates beta-1 and beta-2 receptors. It causes vasodilation through beta-2 stimulation, but its predominant effect is increasing heart rate and cardiac output via beta-1 stimulation. This tends to result in an increase in blood pressure

B) Decreased heart rate:
Isoproterenol generally leads to an increase in heart rate because of its beta-1 adrenergic activity, which stimulates the heart's pacemaker cells. It is commonly used to treat bradycardia (slow heart rate).

C) Increased body temperature:
Although isoproterenol can lead to increased heart rate and blood flow, it does not directly cause a significant increase in body temperature. Temperature changes are more commonly seen with drugs affecting metabolism or those that induce fever.

D) Increased blood pressure:
Isoproterenol stimulates beta-1 receptors in the heart, leading to increased heart rate and cardiac output, which typically results in an increase in blood pressure. However, due to its beta-2 effects, there can be some vasodilation, which may counteract this effect slightly. Despite this, the overall effect of isoproterenol is typically an increase in blood pressure, especially in a shock setting, where improving circulation is critical.

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Correct Answer is B

Explanation

A) Irritable bowel disease: Benztropine is an anticholinergic medication that can reduce gastrointestinal motility, which might exacerbate constipation. However, irritable bowel disease (IBD) is not a contraindication for using benztropine. The drug is more likely to cause concern in conditions where smooth muscle relaxation could worsen symptoms of constipation, but it is not typically withheld due to IBD alone.

B) Glaucoma: Glaucoma, particularly narrow-angle glaucoma, is a contraindication for benztropine use. Benztropine, as an anticholinergic agent, can cause pupil dilation (mydriasis), which can increase intraocular pressure and worsen glaucoma. This is a critical concern for patients with glaucoma, and the healthcare provider should be notified before administering the drug.

C) Asthma: While benztropine can have mild anticholinergic effects that may cause dryness of the respiratory tract, it is not a contraindication for asthma. Beta-agonist inhalers are more commonly prescribed to manage bronchospasm, but the use of benztropine in asthma is not typically harmful unless the patient is experiencing severe respiratory distress. Asthma would not be a primary concern when administering this medication.

D) Hypertension: Benztropine does not directly affect blood pressure in a way that would be a concern for someone with hypertension. While it may cause some mild autonomic changes (like dry mouth or dizziness), hypertension is not a contraindication for the medication. Therefore, there is no specific need to notify the healthcare provider due to a history of hypertension.

A. Hypothalamus and the medulla B. Cranium and sacral area of the spinal cord C. Thoracic and lumbar section of the spinal cord D. Nerve membrane

Correct Answer is C

Explanation

A) Hypothalamus and the medulla: While the hypothalamus and medulla play critical roles in regulating autonomic functions and overall sympathetic nervous system activity, the primary origin of the sympathetic nervous system's neural impulses comes from the spinal cord, specifically in the thoracic and lumbar regions. The hypothalamus and medulla are involved in coordinating and regulating sympathetic activity rather than being the origin of the impulses themselves.

B) Cranium and sacral area of the spinal cord: The cranium and sacral regions are primarily associated with the parasympathetic nervous system, not the sympathetic nervous system. The parasympathetic nervous system's nerve fibers arise from the brainstem and the sacral region, while the sympathetic fibers originate from the thoracic and lumbar areas.

C) Thoracic and lumbar section of the spinal cord: The sympathetic nervous system originates in the thoracolumbar region of the spinal cord, which includes the thoracic and lumbar segments (T1-L2). These regions house the preganglionic neurons whose axons exit the spinal cord and synapse in sympathetic ganglia, leading to the sympathetic effects on organs and tissues. This makes the thoracic and lumbar sections the correct location for the origin of SNS impulses.

D) Nerve membrane: The nerve membrane, or the cellular membrane of individual neurons, is not the location where impulses originate. The origin of the impulses is in the central nervous system (CNS), specifically in the spinal cord for the sympathetic system, not at the level of the individual nerve membranes.

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A patient is admitted to the emergency department in shock. Isoproterenol (Isuprel) is admitted. What would the nurse expect the effect of this drug would be?

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Explanation

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Correct Answer is C

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