When administering an alpha-adrenergic blocker, the nurse should assess the patient for the development of what adverse effect?
Renal failure.
Orthostatic hypotension.
Hyperglycemia.
Respiratory depression.
The Correct Answer is B
Choice A rationale
Alpha-adrenergic blockers primarily affect vascular tone by blocking alpha-1 adrenergic receptors, leading to vasodilation. While severe hypotension from these agents could theoretically compromise renal perfusion, renal failure is not a common or direct adverse effect. The primary concern is related to rapid changes in blood pressure, not a direct nephrotoxic effect on the kidneys themselves.
Choice B rationale
Alpha-adrenergic blockers cause vasodilation by inhibiting the sympathetic nervous system's vasoconstrictive effects on arterioles and veins. This leads to a decrease in peripheral vascular resistance and venous return. When the patient stands up, this vasodilation prevents the normal compensatory increase in blood pressure, resulting in a sudden drop in blood pressure and cerebral perfusion, clinically manifested as orthostatic hypotension.
Choice C rationale
Alpha-adrenergic blockers do not typically cause hyperglycemia. In fact, some alpha-1 antagonists have been shown to improve insulin sensitivity and glucose metabolism in patients with insulin resistance. The primary concern with this class of drugs is their effect on blood pressure, not their influence on glucose regulation, as their mechanism of action is distinct from hormonal pathways that regulate blood glucose levels.
Choice D rationale
Alpha-adrenergic blockers primarily act on the peripheral vascular system and have minimal to no direct effect on the respiratory drive centers in the brainstem. Respiratory depression is more commonly associated with central nervous system depressants, such as opioids or benzodiazepines, which act on different receptor systems. Therefore, this adverse effect is not a typical concern with alpha-adrenergic blocker administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Ranolazine (Ranexa) is an antianginal agent that works by inhibiting the late sodium current in cardiac myocytes. This inhibition leads to a reduction in intracellular calcium overload, improving myocardial relaxation and reducing ventricular wall tension. Unlike many other antianginal drugs, ranolazine does not significantly affect heart rate or blood pressure, making it useful in patients who cannot tolerate the hemodynamic effects of other agents.
Choice B rationale
Ranolazine is not a first-line therapy for angina. It is typically used as a second-line treatment in patients who have not achieved adequate symptom control with beta-blockers, calcium channel blockers, or nitrates. It is often prescribed in combination with other antianginal drugs.
Choice C rationale
Ranolazine is an oral medication available in an extended-release tablet formulation. It is not administered intravenously. The patient takes this medication by mouth, usually twice daily, for the long-term management of chronic angina.
Choice D rationale
Ranexa is metabolized by the liver, specifically via the cytochrome P450 3A (CYP3A) enzyme pathway. Therefore, it is contraindicated or requires significant dose adjustment in patients with moderate to severe hepatic impairment due to the risk of increased plasma concentrations and toxicity.
Correct Answer is C
Explanation
Choice A rationale
Lithium has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Regular blood tests are crucial to monitor serum lithium levels, typically ranging from 0.6 to 1.2 mEq/L, to ensure the dose is therapeutic and to prevent toxicity. This statement indicates a correct understanding of lithium therapy and does not require further teaching.
Choice B rationale
Tremors, nausea, and diarrhea are common early signs of lithium toxicity. The patient should be taught to recognize and report these symptoms to their healthcare provider. This statement demonstrates the patient's awareness of potential adverse effects and the importance of prompt reporting, which is a correct understanding of the medication. The nurse should reinforce this patient teaching.
Choice C rationale
Stopping lithium abruptly can lead to a relapse into a manic or depressive episode. Lithium is a mood stabilizer, and its effectiveness is dependent on consistent, long-term use. This statement indicates a significant misunderstanding of the medication's purpose and the chronicity of bipolar disorder, necessitating immediate and comprehensive further teaching. The patient's illness requires ongoing treatment.
Choice D rationale
This statement shows an understanding of the chronic nature of bipolar disorder and the need for long-term medication adherence to maintain mood stability. Continuing the medication even when feeling better is essential to prevent mood swings and relapse. This statement reflects a correct understanding of the treatment plan, and no further teaching is required.
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