Which three of the following are common adverse effects of beta-blockers?
Bronchospasm
Bradycardia
Hyperglycemia
Fatigue
Correct Answer : A,B,D
A. Bronchospasm: Non-selective beta-blockers inhibit beta-2 receptors located in the bronchial smooth muscle, leading to unintended constriction of the airways. This physiological response significantly increases airway resistance and can trigger acute respiratory distress in patients with underlying asthma or COPD. Clinicians must exercise extreme caution when prescribing these agents to individuals with reactive airway diseases.
B. Bradycardia: Beta-adrenoceptor antagonists decrease the firing rate of the sinoatrial node and slow conduction through the atrioventricular node. This negative chronotropic effect results in a reduced heart rate, which is a primary pharmacological action of the drug class. Excessive blockade can lead to symptomatic bradycardia, requiring a dose adjustment or discontinuation to maintain adequate cardiac output.
C. Hyperglycemia: Beta-blockers do not typically cause an elevation in blood glucose levels as a primary adverse effect. Instead, they are known to mask the sympathetic symptoms of hypoglycemia, such as tachycardia and tremors, which can be dangerous for diabetic patients. They may also slightly impair insulin release, but they are not categorized as hyper-glycemic agents.
D. Fatigue: The reduction in cardiac output and the blockade of peripheral beta-receptors often lead to a profound sense of lethargy or exercise intolerance. Patients frequently report feeling tired because the heart cannot increase its rate sufficiently to meet increased metabolic demands during physical activity. This is one of the most common reasons for patient non-compliance with beta-blocker therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E","F"]
Explanation
A. Pulse ox of 88% on 3 1pm NC: An oxygen saturation of 88% while receiving 3 liters of oxygen indicates significant impairment in gas exchange. This value is below the standard therapeutic target and suggests worsening pulmonary involvement or ventilation-perfusion mismatch. This finding requires immediate medical evaluation and potential adjustment of respiratory support.
B. Lungs are clear to auscultation: This is a normal finding indicating that, at the time of assessment, there is no audible fluid in the alveoli. While heart failure often causes crackles, clear lungs do not require immediate follow-up as an abnormal finding. It serves as a baseline for monitoring future respiratory changes.
C. + 2 pitting edema of the bilateral hands: Edema in the upper extremities is an atypical finding for standard dependent edema and suggests severe systemic fluid retention. It indicates that the venous backup has progressed beyond the lower extremities to involve more superior vascular beds. This requires investigation into the underlying cause of generalized anasarca.
D. + 2 pitting edema of the ankles and feet: Pitting edema in the lower extremities is a clinical manifestation of systemic venous congestion and fluid volume excess. This finding indicates that the current treatment for peripheral edema is not yet effective. The nurse must monitor this to evaluate the patient's response to diuretic therapy.
E. Blood pressure of 150/82: This reading indicates Stage 2 hypertension, which contributes to increased afterload and exacerbates heart failure. Elevated systemic vascular resistance places additional strain on the myocardium and impairs efficient pumping. Persistent hypertension requires pharmacological management to prevent further cardiac remodeling and damage.
F. Respiratory rate is 24: A rate of 24 breaths per minute is tachypneic and suggests the patient is compensating for hypoxia or decreased lung compliance. This increased work of breathing often precedes more severe respiratory distress in fluid-overloaded patients. It correlates with the low pulse oximetry and necessitates closer clinical observation.
G. Abdomen is soft, non-tender, non-distended: This is a normal physical assessment finding indicating the absence of ascites or organomegaly at this time. It suggests that the fluid volume excess has not yet resulted in significant peritoneal accumulation. No acute nursing or medical follow-up is required for this specific result.
H. Client is alert and oriented x 3: Normal mentation indicates that cerebral perfusion is currently adequate despite the patient's low oxygen saturation. It is a positive sign that the patient is not yet experiencing hypercapnia or severe hypoxia-induced encephalopathy. This baseline is used to monitor for any future neurological decline.
I. Heart rate is 88 bpm: A heart rate of 88 is within the normal adult range of 60 to 100 beats per minute. This indicates that the heart is not currently in a state of compensatory tachycardia to maintain cardiac output. It is a stable finding that does not require immediate clinical follow-up.
Correct Answer is D
Explanation
A. Hold the furosemide: Withholding the medication would interrupt the effective treatment of the patient's fluid volume excess. The improvement in edema and weight loss indicates that the drug is working as intended, not that it is no longer needed. Stopping the diuretic prematurely can lead to a rebound of congestive symptoms.
B. Notify the physician: The findings represent a positive, expected response to the prescribed medical regimen for heart failure. There is no evidence of an adverse reaction or a change in status that warrants immediate provider notification. Communication should be reserved for clinical deterioration or lack of therapeutic response.
C. Give the furosemide early: Administering the medication before the scheduled time can lead to fluctuations in serum drug levels and increase the risk of electrolyte imbalances. Maintaining the prescribed interval ensures a steady therapeutic effect and safer diuresis. Nurses should adhere to the established dosing schedule for consistency.
D. Give the scheduled dose: The decrease in pitting edema and weight loss demonstrates that the current dose is therapeutic and effective. Continuing the scheduled regimen is necessary to achieve a complete return to dry weight and optimal hemodynamic stability. The nurse should proceed with administration while monitoring for potential hypokalemia.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
