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 B
Explanation
A. Irregular heart beat with a rate of 86 bpm: While a rate of 86 is within the normal range, the persistence of an irregular rhythm indicates that the client has not returned to normal sinus rhythm. The primary goal of therapy includes rhythm stabilization or better rate control. An irregular rhythm still suggests a deviation from the previous day's successful conversion.
B. No edema noted in the bilateral extremities: The resolution of peripheral edema is a direct indicator that diuretic therapy and heart failure management have been effective. It demonstrates that the excess fluid has been successfully mobilized and excreted from the body. This finding confirms an improvement in the client's congestive state.
C. hypoactive bowel sounds in all 4 quadrants: Hypoactive bowel sounds were present at the start of the assessment and their persistence does not indicate a successful cardiovascular intervention. This finding is likely unrelated to the primary cardiac issue or may be a side effect of other medications. Improvement in cardiac output usually improves systemic perfusion, including the gut.
D. Decreased urine output: Successful treatment with a diuretic like furosemide should result in increased, not decreased, urine output. A decrease in output would suggest worsening renal perfusion or a lack of response to the medication. Effective management of heart failure aims to reduce fluid volume through diuresis.
Correct Answer is C
Explanation
A. Troponin levels will always be elevated: Troponin is a biomarker for myocardial necrosis and cell death, which does not occur in stable angina. In stable angina, the ischemia is transient and reversible, meaning cardiac enzymes typically remain within normal limits. Elevated troponin levels are diagnostic of an acute myocardial infarction rather than angina.
B. The pain is sharp and last for hours, usually radiating down the left leg: Anginal pain is characteristically described as a dull, crushing, or squeezing pressure in the substernal region. It typically lasts only a few minutes and may radiate to the left arm, neck, or jaw, but not the leg. Prolonged pain lasting for hours suggests a more serious acute coronary syndrome.
C. The pain is predictable with exertion and is relieved by rest or nitroglycerin: Stable angina follows a consistent pattern where chest discomfort is triggered by specific levels of physical activity or emotional stress. The increased myocardial demand is eased once the activity stops or when nitroglycerin causes coronary vasodilation. This predictability is the defining feature that differentiates it from unstable angina.
D. Pain occurs at rest and is relieved by nitroglycerin: Pain that occurs without exertion or while the patient is resting is classified as unstable angina or Prinzmetal's angina. This represents a more dangerous clinical state where blood flow is compromised even at baseline. Stable angina requires an external stressor to trigger the imbalance in oxygen supply.
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