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NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
NurseReview.Org - Adrenergic Blockers
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NurseReview.Org - Adrenergic Blockers

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  • PLEASE ENABLE THE DOWNLOAD MENU, SO OTHERS MAY ABLE TO UTILIZE YOUR RESOURCES MORE.THANKS PO
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  • Found a helpful website that I thought may help others. This website has practice exams for various nursing classes as well as videos, presentations, notes, nclex help, and many other tools that already are helping me. Hope they help :-)
    www.RNpedia.com
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  • 1. Drugs Affecting The Autonomic Nervous System Adrenergic Agents and Adrenergic-Blocking Agents
  • 2. Instructors may choose to insert EIC Image #48: The Sympathetic Nervous System in Relationship to the Entire Nervous System
  • 3. Adrenergic Agents <ul><li>Drugs that stimulate the sympathetic nervous system (SNS) </li></ul>
  • 4. Adrenergic Agents <ul><li>Also known as </li></ul><ul><li>adrenergic agonists or sympathomimetics </li></ul>
  • 5. Adrenergic Agents <ul><li>Mimic the effects of the SNS neurotransmitters: </li></ul><ul><li>norepinephrine (NE) and epinephrine (EPI) </li></ul>
  • 6. Adrenergic Receptors <ul><li>Located throughout the body </li></ul><ul><li>Are receptors for the sympathetic neurotransmitters </li></ul><ul><li>Alpha-adrenergic receptors: respond to NE </li></ul><ul><li>Beta-adrenergic receptors: respond to EPI </li></ul>
  • 7. Alpha-Adrenergic Receptors <ul><li>Divided into alpha1 and alpha 2 receptors </li></ul><ul><li>Differentiated by their location on nerves </li></ul>
  • 8. Alpha 1 -Adrenergic Receptors <ul><li>Located on postsynaptic effector cells (the cell, muscle, or organ that the nerve stimulates) </li></ul>
  • 9. Alpha 2 -Adrenergic Receptors <ul><li>Located on presynaptic nerve terminals (the nerve that stimulates the effector cells) </li></ul><ul><li>Control the release of neurotransmitters </li></ul>
  • 10. The predominant alpha-adrenergic agonist responses are: <ul><li>Vasoconstriction and CNS stimulation </li></ul>
  • 11. Beta-Adrenergic Receptors <ul><li>All are located on postsynaptic effector cells </li></ul><ul><li>Beta 1 -adrenergic receptors—located primarily in the heart </li></ul><ul><li>Beta 2 -adrenergic receptors—located in smooth muscle of the bronchioles, arterioles, and visceral organs </li></ul>
  • 12. The beta-adrenergic agonist response results in: <ul><li>Bronchial, GI, and uterine smooth muscle relaxation </li></ul><ul><li>Glycogenolysis </li></ul><ul><li>Cardiac stimulation </li></ul>
  • 13. Dopaminergic Receptors <ul><li>An additional adrenergic receptor </li></ul><ul><li>Stimulated by dopamine </li></ul><ul><li>Causes dilation of the following blood vessels, resulting in INCREASED blood flow </li></ul><ul><ul><li>Renal </li></ul></ul><ul><ul><li>Mesenteric </li></ul></ul><ul><ul><li>Coronary </li></ul></ul><ul><ul><li>Cerebral </li></ul></ul>
  • 14. Adrenergic Receptor Responses to Stimulation <ul><li>LOCATION RECEPTOR RESPONSE Cardiovascular </li></ul><ul><li>Blood vessels alpha 1 and beta 2 Constriction / dilation </li></ul><ul><li>Cardiac muscle beta 1 Increased contractility </li></ul><ul><li>AV Node beta 1 Increased heart rate </li></ul><ul><li>SA Node beta 1 Increased heart rate </li></ul>
  • 15. Adrenergic Receptor Responses to Stimulation <ul><li>LOCATION RECEPTOR RESPONSE Gastrointestinal </li></ul><ul><li>Muscle beta 2 Decreased motility </li></ul><ul><li>Sphincters alpha 1 Constriction </li></ul>
  • 16. Adrenergic Receptor Responses to Stimulation <ul><li>LOCATION RECEPTOR RESPONSE Genitourinary </li></ul><ul><li>Bladder alpha 1 Constriction sphincter </li></ul><ul><li>Penis alpha 1 Ejaculation </li></ul><ul><li>Uterus alpha 1 and beta 2 Contraction/ relaxation </li></ul>
  • 17. Adrenergic Receptor Responses to Stimulation <ul><li>LOCATION RECEPTOR RESPONSE Respiratory </li></ul><ul><li>Bronchial beta 2 Dilation/relaxation muscles </li></ul>
  • 18. Catecholamines <ul><li>Substances that can produce a sympathomimetic response </li></ul><ul><li>Endogenous: </li></ul><ul><li>epinephrine, norepinephrine,dopamine </li></ul><ul><li>Synthetic: </li></ul><ul><li>isoproterenol, dobutamine, phenylephrine </li></ul>
  • 19. Adrenergic Agents Mechanism of Action <ul><li>Direct-acting sympathomimetic: </li></ul><ul><li>Binds directly to the receptor and causes a physiologic response </li></ul>
  • 20. Instructors may choose to insert EIC Image #52: Direct-Acting Sympathomimetics
  • 21. Adrenergic Agents Mechanism of Action <ul><li>Indirect-acting sympathomimetic: </li></ul><ul><li>Causes the release of catecholamine from the storage sites (vesicles) in the nerve endings </li></ul><ul><li>The catecholamine then binds to the receptors and causes a physiologic response </li></ul>
  • 22. Instructors may choose to insert EIC Image #53: Indirect-Acting Sympathomimetics
  • 23. Adrenergic Agents Mechanism of Action <ul><li>Mixed-acting sympathomimetic: </li></ul><ul><li>Directly stimulates the receptor by binding to it </li></ul><ul><li>AND </li></ul><ul><li>Indirectly stimulates the receptor by causing the release of stored neurotransmitters from the vesicles in the nerve endings </li></ul>
  • 24. Instructors may choose to insert EIC Image #54: Mixed-Acting Sympathomimetics
  • 25. Drug Effects of Adrenergic Agents <ul><li>Stimulation of alpha-adrenergic receptors on smooth muscles results in: </li></ul><ul><li>Vasoconstriction of blood vessels </li></ul><ul><li>Relaxation of GI smooth muscles </li></ul><ul><li>Contraction of the uterus and bladder </li></ul><ul><li>Male ejaculation </li></ul><ul><li>Decreased insulin release </li></ul><ul><li>Contraction of the ciliary muscles of the eye (dilated pupils) </li></ul>
  • 26. Drug Effects of Adrenergic Agents <ul><li>Stimulation of beta 2 -adrenergic receptors on the airways results in: </li></ul><ul><li>Bronchodilation (relaxation of the bronchi) </li></ul><ul><li>Uterine relaxation </li></ul><ul><li>Glycogenolysis in the liver </li></ul>
  • 27. Drug Effects of Adrenergic Agents <ul><li>Stimulation of beta1-adrenergic receptors on the myocardium, AV node, and SA node results in CARDIAC STIMULATION: </li></ul><ul><li>Increased force of contraction (positive inotropic effect) </li></ul><ul><li>Increased heart rate (positive chronotropic effect) </li></ul><ul><li>Increased conduction through the AV node (positive dromotropic effect) </li></ul>
  • 28. Adrenergic Agents: Therapeutic Uses <ul><li>Anorexiants: adjuncts to diet in the short-term management of obesity </li></ul><ul><li>Examples: benzphetamine phentermine dextroamphetamine Dexedrine </li></ul>
  • 29. Adrenergic Agents: Therapeutic Uses <ul><li>Bronchodilators: treatment of asthma and bronchitis </li></ul><ul><li>Agents that stimulate beta 2 -adrenergic receptors of bronchial smooth muscles causing relaxation </li></ul><ul><li>Examples: </li></ul><ul><li>albuterol ephedrine epinephrine isoetharine isoproterenol levalbuterol metaproterenol salmeterol terbutaline </li></ul><ul><li>These agents may also affect uterine and vascular smooth muscles. </li></ul>
  • 30. Adrenergic Agents: Therapeutic Uses <ul><li>Reduction of intraocular pressure and mydriasis (pupil dilation): treatment of open-angle glaucoma </li></ul><ul><li>Examples: epinephrine and dipivefrin </li></ul>
  • 31. Adrenergic Agents: Therapeutic Uses <ul><li>Nasal decongestant: </li></ul><ul><li>Intranasal (topical) application causes constriction of dilated arterioles and reduction of nasal blood flow, thus decreasing congestion. </li></ul><ul><li>Examples: epinephrine ephedrine naphazoline phenylephrine tetrahydrozoline </li></ul>
  • 32. Adrenergic Agents: Therapeutic Uses <ul><li>Ophthalmic </li></ul><ul><li>Topical application to the eye surface affects the vasculature of the eye, stimulating alpha receptors on small arterioles, thus relieving conjunctival congestion. </li></ul><ul><li>Examples: epinephrine naphazoline phenylephrine tetrahydrozoline </li></ul>
  • 33. Adrenergic Agents: Therapeutic Uses <ul><li>Vasoactive sympathomimetics (pressors, inotropes), also called cardioselective sympathomimetics </li></ul><ul><li>Used to support the heart during cardiac failure or shock. </li></ul><ul><li>Examples: </li></ul><ul><li>dobutamine dopamine ephedrine epinephrine fenoldopam isoproterenol methoxamine norepinephrine phenylephrine </li></ul>
  • 34. Adrenergic Agents: Side Effects <ul><li>Alpha-Adrenergic Effects </li></ul><ul><li>CNS: </li></ul><ul><ul><li>headache, restlessness, excitement, insomnia, euphoria </li></ul></ul><ul><li>Cardiovascular: </li></ul><ul><ul><li>palpitations (dysrhythmias), tachycardia, vasoconstriction, hypertension </li></ul></ul><ul><li>Other: </li></ul><ul><ul><li>anorexia, dry mouth, nausea, vomiting, taste changes (rare) </li></ul></ul>
  • 35. Adrenergic Agents: Side Effects <ul><li>Beta-Adrenergic Effects </li></ul><ul><li>CNS: </li></ul><ul><ul><li>mild tremors, headache, nervousness, dizziness </li></ul></ul><ul><li>Cardiovascular: </li></ul><ul><ul><li>increased heart rate, palpitations (dysrhythmias), fluctuations in BP </li></ul></ul><ul><li>Other: </li></ul><ul><ul><li>sweating, nausea, vomiting, muscle cramps </li></ul></ul>
  • 36. Adrenergic Agents: Interactions <ul><li>Anesthetic agents </li></ul><ul><li>Tricyclic antidepressants </li></ul><ul><li>MAOIs </li></ul><ul><li>Antihistamines </li></ul><ul><li>Thyroid preparations </li></ul><ul><li>Antihypertensives </li></ul><ul><li>Will directly antagonize another adrenergic agent, resulting in reduced effects </li></ul>
  • 37. Adrenergic Agents: Nursing Implications <ul><li>Assess for allergies and history of hypertension, cardiac dysrhythmias, or other cardiovascular disease. </li></ul><ul><li>Assess renal, hepatic, and cardiac function before treatment. </li></ul><ul><li>Perform baseline assessment of vital signs, peripheral pulses, skin color, temperature, and capillary refill. Include postural blood pressure and pulse. </li></ul><ul><li>Follow administration guidelines carefully. </li></ul>
  • 38. Adrenergic Agents: Nursing Implications <ul><li>IV administration: </li></ul><ul><li>Check IV site often for infiltration </li></ul><ul><li>Use clear IV solutions </li></ul><ul><li>Use an infusion device/IV pump </li></ul><ul><li>Infuse agent slowly to avoid dangerous cardiovascular effects </li></ul><ul><li>Monitor cardiac rhythm </li></ul>
  • 39. Adrenergic Agents: Nursing Implications <ul><li>With chronic lung disease: </li></ul><ul><li>Instruct patients to avoid factors that exacerbate their condition. </li></ul><ul><li>Encourage fluid intake (up to 3000 mL per day) if permitted. </li></ul><ul><li>Educate about proper dosing and equipment care. </li></ul><ul><li>Salmeterol is indicated for PREVENTION of bronchospasms, not management of acute symptoms. </li></ul>
  • 40. Adrenergic Agents: Nursing Implications <ul><li>Overuse of nasal decongestants may cause rebound nasal congestion or ulcerations. </li></ul><ul><li>Avoid OTC or other medications because of possible interactions. </li></ul><ul><li>Administering two adrenergic agents together may precipitate severe cardiovascular effects such as tachycardia or hypertension. </li></ul><ul><li>Inform patients taking inhaled isoproterenol that their sputum or saliva may turn pink. </li></ul>
  • 41. Adrenergic Agents: Nursing Implications <ul><li>Monitor for therapeutic effects (cardiovascular uses): </li></ul><ul><li>Decreased edema </li></ul><ul><li>Increased urinary output </li></ul><ul><li>Return to normal vital signs </li></ul><ul><li>Improved skin color and temperature </li></ul><ul><li>Increased LOC </li></ul>
  • 42. Adrenergic Agents: Nursing Implications <ul><li>Monitor for therapeutic effects (asthma): </li></ul><ul><li>Return to normal respiratory rate </li></ul><ul><li>Improved breath sounds, fewer rales </li></ul><ul><li>Increased air exchange </li></ul><ul><li>Decreased cough </li></ul><ul><li>Less dyspnea </li></ul><ul><li>Improved blood gases </li></ul><ul><li>Increased activity tolerance </li></ul>
  • 43. Adrenergic-Blocking Agents <ul><li>Bind to adrenergic receptors, but inhibit or block stimulation of the sympathetic nervous system (SNS) </li></ul>
  • 44. Adrenergic Blocking Agents <ul><li>Have the opposite effect of adrenergic agents </li></ul><ul><li>Also known as </li></ul><ul><ul><li>adrenergic antagonists or sympatholytics </li></ul></ul>
  • 45. Adrenergic Blocking Agents <ul><li>Sympatholytics inhibit—or LYSE—sympathetic neurotransmitters (norepinephrine and epinephrine) </li></ul>
  • 46. Adrenergic Blocking Agents <ul><li>Classified by the type of adrenergic receptor they block </li></ul><ul><li>Alpha 1 and alpha 2 receptors </li></ul><ul><li>Beta 1 and beta 2 receptors </li></ul>
  • 47. Instructors may choose to insert EIC Image #55: Alpha-Blocker Mechanisms
  • 48. Adrenergic-Blocking Agents: Drug Effects and Therapeutic Uses <ul><li>Ergot Alkaloids (Alpha-Blockers) </li></ul><ul><li>Constrict dilated arteries going to the brain (carotid arteries) </li></ul><ul><li>Used to treat vascular headaches (migraines) </li></ul><ul><li>Stimulate uterine contractions by inducing vasoconstriction </li></ul><ul><li>Used to control postpartum bleeding </li></ul>
  • 49. Adrenergic-Blocking Agents: Drug Effects and Therapeutic Uses <ul><li>Alpha-Blockers </li></ul><ul><li>Cause both arterial and venous dilation, reducing peripheral vascular resistance and BP </li></ul><ul><li>Used to treat hypertension </li></ul><ul><li>Effect on receptors on prostate gland and bladder decreased resistance to urinary outflow, thus reducing urinary obstruction and relieving effects of BPH </li></ul>
  • 50. Adrenergic-Blocking Agents: Drug Effects and Therapeutic Uses <ul><li>Alpha-Blockers </li></ul><ul><li>Phentolamine </li></ul><ul><ul><li>Quickly reverses the potent vasoconstrictive effects of extravasated vasopressors such as norepinephrine or epinephrine. </li></ul></ul><ul><ul><li>Restores blood flow and prevents tissue necrosis. </li></ul></ul>
  • 51. Adrenergic-Blocking Agents: Side Effects <ul><li>Alpha Blockers </li></ul><ul><li>Body System Side/Adverse Effects </li></ul><ul><li>Cardiovascular Palpitations, orthostatic hypotension, tachycardia, edema, dysrhythmias, chest pain </li></ul><ul><li>CNS Dizziness, headache, drowsiness, anxiety, depression, vertigo, weakness, numbness, fatigue </li></ul>
  • 52. Adrenergic-Blocking Agents: Side Effects <ul><li>Alpha Blockers </li></ul><ul><li>Body System Side/Adverse Effects </li></ul><ul><li>Gastrointestinal Nausea, vomiting, diarrhea, constipation, abdominal pain </li></ul><ul><li>Other Incontinence, nose bleeding, tinnitus, dry mouth, pharyngitis, rhinitis </li></ul>
  • 53. Beta Blockers <ul><li>Block stimulation of beta receptors in the SNS </li></ul><ul><li>Compete with norepinephrine and epinephrine </li></ul><ul><li>Selective and nonselective beta blockers </li></ul>
  • 54. Beta Receptors <ul><li>Beta 1 Receptors </li></ul><ul><li>Located primarily on the heart </li></ul><ul><li>Beta blockers selective for these receptors are called cardioselective beta blockers </li></ul>
  • 55. Beta Receptors <ul><li>Beta 2 Receptors </li></ul><ul><li>Located primarily on smooth muscles of bronchioles and blood vessels </li></ul>
  • 56. Nonspecific Beta Blockers <ul><li>Beta blockers that block both beta 1 and beta 2 receptors </li></ul>
  • 57. Beta Blockers: Mechanism of Action <ul><li>Cardioselective (Beta1) </li></ul><ul><li>Decreases heart rate </li></ul><ul><li>Prolongs SA node recovery </li></ul><ul><li>Slows conduction rate through the AV node </li></ul><ul><li>Decreases myocardial contractility, thus decreasing myocardial oxygen demand </li></ul>
  • 58. Beta Blockers: Mechanism of Action <ul><li>Nonspecific (Beta 1 and Beta 2 ) </li></ul><ul><li>Effects on heart: Same as cardioselective </li></ul><ul><li>Bronchioles: Constriction, resulting in narrowing of airways and shortness of breath </li></ul><ul><li>Blood vessels: Vasoconstriction </li></ul>
  • 59. Beta Blockers: Therapeutic Uses <ul><li>Anti-angina: decreases demand for myocardial oxygen </li></ul><ul><li>Cardioprotective: inhibits stimulation by circulating catecholamines </li></ul><ul><li>Class II antidysrhythmic </li></ul>
  • 60. Beta Blockers: Therapeutic Uses <ul><li>Antihypertensive </li></ul><ul><li>Treatment of migraine headaches </li></ul><ul><li>Glaucoma (topical use) </li></ul>
  • 61. Beta Blockers: Side Effects <ul><li>Body System Side/Adverse Effects </li></ul><ul><li>Blood Agranulocytosis, thrombocytopenia </li></ul><ul><li>Cardiovascular AV block, bradycardia, congestive heart failure, peripheral vascular insufficiency </li></ul><ul><li>CNS Dizziness, mental depression, lethargy, hallucinations </li></ul>
  • 62. Adrenergic-Blocking Agents: Side Effects <ul><li>Beta Blockers </li></ul><ul><li>Body System Side/Adverse Effects </li></ul><ul><li>Gastrointestinal Nausea, dry mouth, vomiting, diarrhea, cramps, ischemic colitis </li></ul><ul><li>Other Impotence, rash, alopecia, bronchospasms </li></ul>
  • 63. Adrenergic Blocking Agents: Nursing Implications <ul><li>Assess for allergies and history of COPD, hypotension, cardiac dysrhythmias, bradycardia, CHF, or other cardiovascular problems </li></ul><ul><ul><li>Any preexisting condition that might be exacerbated by the use of these agents might be a CONTRAINDICATION to their use. </li></ul></ul>
  • 64. Adrenergic Blocking Agents: Nursing Implications <ul><li>Remember that alpha blockers may precipitate hypotension. </li></ul><ul><li>Remember that beta blockers may precipitate bradycardia, hypotension, heart block, CHF, and bronchoconstriction. </li></ul>
  • 65. Adrenergic Blocking Agents: Nursing Implications <ul><li>Avoid OTC medications because of possible interactions. </li></ul><ul><li>Possible drug interactions may occur with: </li></ul><ul><ul><li>Antacids (aluminum hydroxide type) </li></ul></ul><ul><ul><li>Antimuscarinics/anticholinergics </li></ul></ul><ul><ul><li>Diuretics and cardiovascular drugs </li></ul></ul><ul><ul><li>Neuromuscular blocking agents </li></ul></ul><ul><ul><li>Oral hypoglycemic agents </li></ul></ul>
  • 66. Adrenergic Blocking Agents: Nursing Implications <ul><li>Encourage patients to take medications as prescribed. </li></ul><ul><li>These medications should never be stopped abruptly. </li></ul><ul><li>Report constipation or the development of any urinary hesitancy or bladder distention. </li></ul>
  • 67. Adrenergic Blocking Agents: Nursing Implications <ul><li>Teach patients to change positions slowly to prevent or minimize postural hypotension. </li></ul><ul><li>Avoid caffeine (excessive irritability). </li></ul><ul><li>Avoid alcohol ingestion and hazardous activities until blood levels become stable. </li></ul><ul><li>Patients should notify their physician if palpitations, dyspnea, nausea, or vomiting occur. </li></ul>
  • 68. Beta Blocking Agents: Nursing Implications <ul><li>Rebound hypertension or chest pain may occur if this medication is discontinued abruptly. </li></ul><ul><li>Patients should notify their physician if they become ill and unable to take medication. </li></ul><ul><li>Inform patients that they may notice a decrease in their tolerance for exercise; dizziness and fainting may occur with increased activity. Notify the physician if these problems occur. </li></ul>
  • 69. Beta Blocking Agents: Nursing Implications <ul><li>Patients should report the following to their physician: </li></ul><ul><li>Weight gain of more than 2 pounds (1 kg) within a week </li></ul><ul><li>Edema of the feet or ankles </li></ul><ul><li>Shortness of breath </li></ul><ul><li>Excessive fatigue or weakness </li></ul><ul><li>Syncope or dizziness </li></ul>
  • 70. Adrenergic Blocking Agents: Nursing Implications <ul><li>Monitor for side effects, including: </li></ul><ul><li>Hypotension Fatigue </li></ul><ul><li>Tachycardia (alpha blockers) Lethargy </li></ul><ul><li>Bradycardia Depression </li></ul><ul><li>Heart block Insomnia </li></ul><ul><li>CHF Vivid nightmares </li></ul><ul><li>Increased airway resistance </li></ul>
  • 71. Adrenergic Blocking Agents: Nursing Implications <ul><li>Monitor for therapeutic effects </li></ul><ul><li>Decreased chest pain in patients with angina </li></ul><ul><li>Return to normal BP and P </li></ul><ul><li>Other specific effects, depending on the use </li></ul>

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