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Questions and Answers
A patient is prescribed norepinephrine for hypotension. What is the MOST critical nursing intervention during the administration of this medication?
A patient is prescribed norepinephrine for hypotension. What is the MOST critical nursing intervention during the administration of this medication?
- Checking peripheral potassium levels
- Continuous blood pressure monitoring via arterial line (correct)
- Assessing the patient's level of consciousness every hour
- Monitoring urine output every 4 hours
A patient experiencing anaphylaxis is given epinephrine. Which of the following effects would the nurse expect to observe?
A patient experiencing anaphylaxis is given epinephrine. Which of the following effects would the nurse expect to observe?
- Decreased blood pressure and vasodilation
- Decreased heart rate and bronchoconstriction
- Increased heart rate and bronchodilation (correct)
- Increased blood pressure and decreased respiratory rate
A patient in cardiogenic shock is receiving a dopamine infusion. The nurse notes a significant increase in urine output. What is the MOST likely explanation for this?
A patient in cardiogenic shock is receiving a dopamine infusion. The nurse notes a significant increase in urine output. What is the MOST likely explanation for this?
- The dopamine is causing hyperglycemia leading to osmotic diuresis
- The dopamine is causing diabetes insipidus
- The patient is experiencing an allergic reaction
- The dopamine is improving renal perfusion at a low dose (correct)
A patient receiving dobutamine reports chest pain. What is the nurse's priority action?
A patient receiving dobutamine reports chest pain. What is the nurse's priority action?
After administering adenosine for supraventricular tachycardia (SVT), a patient experiences a brief period of asystole. What is the nurse's BEST response?
After administering adenosine for supraventricular tachycardia (SVT), a patient experiences a brief period of asystole. What is the nurse's BEST response?
Which assessment is MOST critical for a nurse to perform before administering alteplase to a patient with a suspected acute ischemic stroke?
Which assessment is MOST critical for a nurse to perform before administering alteplase to a patient with a suspected acute ischemic stroke?
A patient is prescribed digoxin for heart failure. Which of the following findings would warrant holding the dose and notifying the provider?
A patient is prescribed digoxin for heart failure. Which of the following findings would warrant holding the dose and notifying the provider?
A patient is prescribed norepinephrine. Which of the following manifestations indicates extravasation at the IV site?
A patient is prescribed norepinephrine. Which of the following manifestations indicates extravasation at the IV site?
A patient with a history of asthma is prescribed epinephrine via intramuscular injection for an allergic reaction to peanuts. What specific instruction should the nurse provide regarding the injection site?
A patient with a history of asthma is prescribed epinephrine via intramuscular injection for an allergic reaction to peanuts. What specific instruction should the nurse provide regarding the injection site?
A patient is receiving dopamine and the nurse assesses a blood pressure of 70/40 mmHg, HR 50 bpm, and decreasing urine output. What action should the nurse prioritize?
A patient is receiving dopamine and the nurse assesses a blood pressure of 70/40 mmHg, HR 50 bpm, and decreasing urine output. What action should the nurse prioritize?
Flashcards
Norepinephrine
Norepinephrine
Increases BP and cardiac output; used for hypotension and shock.
Epinephrine
Epinephrine
Increases HR, bronchodilation, vasoconstriction; used for anaphylaxis and cardiac arrest.
Dopamine
Dopamine
Increases BP, cardiac output, and renal perfusion (at low doses); used for shock and heart failure.
Dobutamine
Dobutamine
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Adenosine
Adenosine
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Alteplase
Alteplase
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Digoxin
Digoxin
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Inotropic Agent
Inotropic Agent
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Vasopressor
Vasopressor
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Antiarrhythmic
Antiarrhythmic
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Study Notes
- Adrenergic agonists, inotropic agents, antiarrhythmics, thrombolytics, and cardiac glycosides are some drug classes.
Norepinephrine
- Class: Vasopressor, adrenergic agonist.
- Indications include hypotension and shock.
- Increases BP and cardiac output.
- Side effects include hypertension, arrhythmias, headache, and ischemia.
- Requires continuous BP monitoring.
- Central line preferred to prevent extravasation.
- Patients should be informed about potential IV site pain.
- Patients should report signs of chest pain or irregular heartbeats.
- Assess BP, HR, peripheral perfusion, and IV patency before administering.
Epinephrine
- Class: Adrenergic agonist.
- Indications: Anaphylaxis, cardiac arrest, asthma exacerbation
- Increases HR, bronchodilation, vasoconstriction.
- Side effects include tachycardia, hypertension, anxiety, palpitations.
- Vital signs should be monitored closely.
- Administer in large muscle for IM.
- Flush IV well after administration.
- If prescribed, patients should carry an epinephrine auto-injector.
- Teaching on proper injection technique is necessary.
- Assess BP, HR, respiratory status, and allergic reaction symptoms before administering.
Dopamine
- Class: Inotropic agent, vasopressor.
- Indications: Shock, heart failure, hypotension.
- Increases BP and cardiac output
- At low doses, increases renal perfusion.
- Side effects include tachycardia, arrhythmias, and angina.
- Administer via IV pump.
- Titrate dose based on BP response.
- Patients should report chest pain or palpitations.
- Assess BP, HR, urine output, and peripheral perfusion before administering.
Dobutamine
- Class: Inotropic agent.
- Indications: Heart failure, cardiogenic shock.
- Increases cardiac output without significant change in HR.
- Side effects include hypertension, arrhythmias, and headache.
- Continuous ECG monitoring is needed.
- Adjust dose based on BP response.
- Patients need to report chest pain or irregular heartbeat.
- Assess BP, HR, and cardiac function before administering.
Adenosine
- Class: Antiarrhythmic.
- Indication: Supraventricular tachycardia (SVT).
- Slows conduction through AV node.
- Side effects include transient asystole, chest pain, and flushing.
- Administer rapidly via IV push.
- Ensure resuscitation equipment is ready.
- Warn about brief period of chest discomfort or flushing.
- Assess ECG, HR, and BP before administering.
Alteplase
- Class: Thrombolytic.
- Indications: Acute ischemic stroke, MI, pulmonary embolism.
- Breaks down clots.
- Side effects include bleeding and hypotension.
- Monitor for bleeding.
- Avoid unnecessary punctures.
- Report signs of bleeding or bruising.
- Assess PT/INR, aPTT, platelets, and BP before administering.
Digoxin
- Class: Cardiac glycoside.
- Indications: Heart failure, atrial fibrillation.
- Increases contractility and decreases HR.
- Side effects include bradycardia, nausea, and visual disturbances.
- Monitor for toxicity (nausea, vision changes, bradycardia).
- Take as prescribed.
- Monitor pulse before taking.
- Assess HR before administering.
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Description
Overview of adrenergic agonists like norepinephrine and epinephrine. These drugs, including vasopressors, are used for hypotension, shock, anaphylaxis, and cardiac arrest. Monitoring vital signs and patient education regarding side effects are crucial.
