Author Question: A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which ... (Read 173 times)

renzo156 · **on:** Jul 23, 2018

A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching?

a. Catecholamines may be given orally.
b. Catecholamines often require continuous infusion to be effective.
c. Noncatecholamines do not cross the blood-brain barrier.
d. Noncatecholamines undergo rapid de-gradation by monoamine oxidase.

Question 2

An older adult patient who has cancer and Alzheimer's disease is crying but shakes her head no when asked about pain. The prescriber has ordered morphine sulfate 2 to 4 mg IV every 2 hours PRN pain.

It has been 4 hours since a dose has been given. What will the nurse do? a. Administer 4 mg of morphine and monitor this patient's verbal and nonverbal res-ponses.
b. Give 2 mg of morphine for pain to avoid increasing this patient's level of confusion.
c. Request an order for a nonopioid analgesic or an antidepressant adjuvant analgesic.
d. Withhold any analgesic at this time and reassess the patient in 30 to 60 minutes.

janeli · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

B
Catecholamines undergo rapid degradation by monoamine oxidase (MAO) and cate-chol-O-methyltransferase (COMT). Consequently, they have a brief duration of action, and con-tinuous infusion often is required to maintain the drug's effects. Catecholamines cannot be used orally. Catecholamines do not cross the blood-brain barrier; noncatecholamines do. Noncatecho-lamines are not degraded by MAO.

Answer to Question 2

A
Older adult patients often are undertreated for pain, because assessing pain is difficult in patients with cognitive impairment and because practitioners often believe that reduced dosages are ne-cessary to alleviate side effects. This patient does not verbalize pain, but her nonverbal cue (cry-ing) indicates that pain is present. The nurse should give the higher dose, especially because the dosing interval has already been exceeded, and then monitor the patient's response to the medi-cation. Giving 2 mg to avoid side effects is not indicated; patients with Alzheimer's disease will continue to have confusion unrelated to the opioid. Nonopioid analgesics and antidepressants are not indicated. Withholding pain medication is not appropriate, because this patient shows non-verbal signs of pain.