The nurse will monitor the patient taking albuterol (Proventil) for which conditions? Select all that apply.
Palpitations
Hypertension
Hypoglycemia
Bronchospasm
Uterine contractions
Correct Answer : A,B
Albuterol (Proventil) is a short-acting beta-2 adrenergic agonist commonly used to relieve bronchospasm in conditions like asthma and COPD. While effective in relaxing bronchial smooth muscle, its adrenergic effects can also stimulate beta-1 receptors at higher doses, leading to cardiovascular side effects that nurses must monitor carefully.
Rationale for correct answers:
1. Palpitations – Albuterol can cause cardiac stimulation by activating beta-1 receptors at higher or repeated doses, resulting in palpitations, tachycardia, or other dysrhythmias.
2. Hypertension – Beta-agonists may increase heart rate and contractility, potentially raising blood pressure in some patients, especially in those with underlying cardiovascular conditions.
Rationale for incorrect answers:
3. Hypoglycemia – Albuterol is more commonly associated with hyperglycemia, not hypoglycemia. It stimulates glycogenolysis, potentially increasing blood glucose levels.
4. Bronchospasm – Albuterol is used to relieve, not cause, bronchospasm. However, paradoxical bronchospasm is rare and would be an adverse reaction, not a typical side effect to monitor for routinely.
5. Uterine contractions – Albuterol is sometimes used off-label to inhibit uterine contractions due to its smooth muscle relaxing effects. It does not typically cause uterine contractions.
Take-home points:
- Albuterol may cause palpitations and increased blood pressure due to beta-1 receptor stimulation at higher doses.
- Nurses should monitor cardiovascular effects when administering adrenergic agonists like albuterol.
- Though primarily a bronchodilator, albuterol can have systemic effects, especially if overused.
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Related Questions
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"C","dropdown-group-3":"D","dropdown-group-4":"C"}
Explanation
Rationale for correct answer:
Pilocarpine is a direct-acting cholinergic agonist that stimulates muscarinic receptors. It is primarily used in the treatment of glaucoma to reduce intraocular pressure by increasing aqueous humor outflow. Nurses administering cholinergic agents like pilocarpine should anticipate both therapeutic effects and systemic adverse effects associated with parasympathetic activation.
Pilocarpine
Pilocarpine is the appropriate choice as it is a cholinergic agent used in ophthalmology to treat glaucoma by activating muscarinic receptors in the eye. This enhances aqueous humor drainage, thereby lowering intraocular pressure.
Glaucoma; reducing intraocular pressure
Glaucoma is managed by lowering intraocular pressure to prevent optic nerve damage. Pilocarpine constricts the pupil (miosis) and opens the trabecular meshwork, facilitating fluid drainage from the anterior chamber.
Bradycardia
Systemic absorption of pilocarpine may stimulate muscarinic receptors in the heart, resulting in slowed heart rate (bradycardia), especially with higher doses or in sensitive individuals. This is a common systemic adverse effect of cholinergic agonists.
Take-home points:
- Pilocarpine is a cholinergic agonist used to treat glaucoma by lowering intraocular pressure via miosis and enhanced aqueous humor outflow.
- Nurses should monitor for systemic cholinergic effects, including bradycardia, excessive salivation, or sweating.
- Understanding the systemic effects of ophthalmic medications is crucial, especially in older adults or those with preexisting cardiac conditions.
Correct Answer is A
Explanation
Phenylephrine (Neo-Synephrine) is a selective alpha-1 adrenergic agonist used for nasal congestion, hypotension, and sometimes to prolong local anesthetic action. Due to its mechanism of vasoconstriction via stimulation of alpha-1 receptors, it can lead to systemic cardiovascular and central nervous system effects that nurses must monitor closely after administration.
Rationale for correct answer:
1. Insomnia, nervousness, and hypertension
These are common adverse effects of phenylephrine due to CNS stimulation and peripheral vasoconstriction. The alpha-1 receptor activation increases blood pressure, and stimulation of the sympathetic nervous system can lead to restlessness and sleep disturbances.
Rationale for incorrect answer:
2. Nausea, vomiting, and hypotension
While nausea and vomiting can occasionally occur, hypotension is not expected with phenylephrine since it is primarily used to increase blood pressure in hypotensive states through vasoconstriction.
3. Dry mouth, drowsiness, and dyspnea
These symptoms are more consistent with anticholinergic agents or CNS depressants, not alpha-1 agonists. Phenylephrine does not typically cause drowsiness or impair airway function.
4. Increased bronchial secretions, hypotension, and bradycardia
Phenylephrine does not increase secretions or cause hypotension. While reflex bradycardia may occur from elevated BP, this triad does not represent typical adverse effects of the drug.
Take-home points:
- Phenylephrine, an alpha-1 agonist, causes vasoconstriction, which can lead to hypertension and reflex bradycardia.
- Nurses should monitor for CNS stimulation symptoms like insomnia and nervousness after administration.
- Adverse effects align with sympathomimetic activity, not parasympathetic or cholinergic effects.
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