An adult patient is brought to the emergency department for ...

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An adult patient is brought to the emergency department for treatment of an asthma exacerbation.
 
  The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has
  a. over-used the albuterol.
  b. not been using albuterol.
  c. taken a beta-adrenergic blocker.
  d. taken a monoamine oxidase (MAO) inhibitor.

Question 2

The nurse administers subcutaneous epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor the patient for which symptom?
 
  a. Bradycardia
  b. Decreased urine output
  c. Hypotension
  d. Nausea and vomiting

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Answer to Question 1

ANS: A
High doses of albuterol may affect beta1 receptors, causing an increase in heart rate. Patients having an asthma exacerbation may over-use their albuterol inhalers when seeking relief. Patients may have wheezing and increased heart rate during an untreated asthma exacerbation, but they will not have tremors and restlessness.

Answer to Question 2

ANS: B
Epinephrine can cause renal vasoconstriction and thereby reduce renal perfusion and decrease urinary output. Epinephrine causes tachycardia and elevates blood pressure. Nausea and vomiting are not expected to occur.

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Excellent

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TYSM