Question

ADN 235

Unit 2 Study Guide

1. What responses does the sympathetic nervous system regulate?

2. Discuss the cholinergic drugs and their possible actions, including adverse side effects.

3. What client education is appropriate for clients receiving pharmacotherapy with cholinergic drugs? Cholinergic blocking drugs?

4. What types of responses that occur when drugs activate alpha1-, alpha2-, beta1-, beta2- or beta3-adrenergic receptors. Give an example of a medication for each.

5. Explain how to provide client education on self-administration of subcutaneous epinephrine via auto-injector.

6. What should the nurse include the education for a client taking a beta blocker? What should the nurse be certain to include as a priority in her assessment?

7. Explain the use and action of adrenergic blocking agents (i.e. Aldomet) in the body. List common side effects.

8. Define the terms seizure, convulsion, and epilepsy.

9. Identify partial and generalized seizures by subtype and include S/S of each?

10. What is the nurse’s role in pharmacologic management of seizures and epilepsy and what is important to include in client education?

11. What are opioid agonists? Give 3 examples, including the intended effect as well as common adverse effects.

12. What is the role of opioid antagonists in the diagnosis and treatment of acute opioid toxicity? How are opioid antagonists administered?

13. What type of pain medication is acetaminophen (Tylenol)? When would it be contraindicated?

14. What is the rationale for adding epinephrine to lidocaine for local anesthesia?

15. What would the nurse include in the post-procedure assessment of a client receiving local anesthesia with viscous lidocaine during endoscopy?

16. When clients are given anesthesia via inhaled route as a volatile liquid, what adverse effects does the nurse need to be aware of?

17. In client’s receiving the anesthetic succinylcholine(Anectine), what is the nurse’s priority assessment?

18. What is the purpose of medication treatment in Parkinson’s disease? Explain what about Levodopa (and similar medications) makes it most effective?

19. What are the goals of initial medication treatment for Alzheimer’s disease?

20. What client and family education is necessary regarding Alzheimer’s disease medication?

21. What non-pharmacologic interventions can be used for clients experiencing spasticity?

22. For client’s with degenerative disorders experiencing spasticity, what medication therapy is commonly prescribed? What client education is necessary for these medications due to common adverse effects?

23. Which lab would be a priority for a patient receiving Dantrolene or a client suspected of Malignant Hyperthermia?

Answer 1

1. What responses does the sympathetic nervous system regulate?

Answer: -

The following are the responses of sympathetic nervous system

a. Dilates pupil

b. Inhibits salivation

c. Bronchial dilation

d. Inhibits digestion

e. Increase heart rate

f. Stimulates glucose release from liver

g. Stimulates epinephrine and norepinephrine release from kidneys

h. Relaxes bladder

i. Contracts rectum

j. Ejaculation of sperm

k. Increases contractility of small intestine and large intestine

2. Discuss the cholinergic drugs and their possible actions, including adverse side effects.

Answer:

Cholinergic drugs are those drugs which act upon neurotransmission especially parasympathetic nervous system. cholinergic agonists work by directly binding to and activating the muscarinic receptors.

Action: cholinergic drugs act upon cholinesterase enzyme stimulating the production of acetyl choline at neuro-neuronal junction, causing more neural response. They may also be called as mimicking agents for neuro transmission as they increase impulses within parasympathetic nervous system.

Indications: myasthenia gravis, dementia, ophthalmology, post-operative urinary retention, neurogenic bladder, xerostomia, anticholinergic overdose, tensilon test. Etc…

Adverse effects: constriction of pupil, bronchial constriction, narrowed airway, increased salivation, bradycardia, hypotension, head ache, dizziness, convulsions, abdominal cramps.

3. What client education is appropriate for clients receiving pharmacotherapy with cholinergic drugs? Cholinergic blocking drugs?

Educate the client about possible uses of the anti-cholinergic drugs,

These are the drugs which block the parasympathetic nervous system stimulation by blocking the neuro – neuronal junction.

Educate that these drugs decrease all kinds of secretions

Educate that these decrease the peristalsis movement

Educate that these drugs cause bronchodilation and decreases respiratory secretions

Educate that these drugs are used with caution in patients with GI infections, benign prostatic hypertrophy, urinary retention, hyperthyroidism, hepatic or renal disease, and hypertension.

4.What types of responses that occur when drugs activate alpha1-, alpha2-, beta1-, beta2- or beta3-adrenergic receptors. Give an example of a medication for each.

These are adrenergic drugs which binds to adrenergic receptors all over the body

The responses of these are as follows

Receptor	Action	Drug of choice
Alpha-1 receptor:	Smooth muscle contraction, mydriasis	Phenylephrine
Alpha-2 receptor:	Mixed smooth muscle effects	Methyldopa
Beta-1 receptor:	Increased cardiac chronotropic and inotropic effects	Dobutamine
Beta-2 receptor:	Bronchodilation	Albuterol
Beta-3 receptor:	Increased lipolysis	Mirabegron