ANS overview
What are the two divisions of the ANS?
A. Central Nervous System (CNS) and Peripheral Nervous System (PNS)
B. Sympathetic Nervous System (SNS) and Parasympathetic Nervous System (PNS)
C. Motor and Sensory Division
B. sympathetic nervous system (SNS) & parasympathetic nervous system (PNS)
Another word for cholinergic is:
A. adrenergic
B. muscarinic
B. muscarinic
After administering tolterodine (Detrol), an anticholinergic, your patient starts to void less in frequency and volume than before. With this result you:
A. page the doctor, they're experiencing retention
B. are pleased, because this is what is expected of a cholinergic agonist medication
C. increase IV fluids and encourage PO fluids
B. are pleased, this is what is expected
Epinephrine is a nonselective adrenergic agonist that stimulates both alpha and beta receptors in the body. With that knowledge, what situation is epinephrine most appropriate for? (select all that apply)
A. runny nose
B. CPR
C. labor
D. anaphylaxis
B and D (CPR and anaphylaxis)
these drugs will __ (increase or decrease) effects of SNS
decrease/block
What is the main neurotransmitter of SNS?
A. acetylcholine
B. norepinephrine
C. GABA
D. dopamine
norepinephrine
The nurse administers a cholinergic agonist medication to a patient with urinary retention. Because this medication is contracting the bladder, we know that it ___ the effects of the PNS?
a. increases
b. decreases
a. increase
Some conditions you would expect to see a cholinergic antagonist used for include:
A. urinary retention
B. Parkinson's disease
C. antidote for poisoning from muscarinic drugs
D. B and C
D. all the above
D. B and C
urinary retention should be replaced with urge incontinence
alpha 1 agonist medications ___ (constrict/dilate)
beta 1 agonist receptors are mainly found on the __ (heart/lungs)
beta 2 agonist receptors are mainly found on the __ (heart/lungs)
the main adrenergic agonist neurotransmitter is __ (norepinephrine/acetylcholine)
alpha 1 - constrict
beta 1 - heart
beta 2 - lungs
trick: "2 lungs, 1 heart"
norepinephrine
If Alpha 1 agonists cause constriction, Alpha 1 adrenergic antagonists create the opposite effect. Thus, when administering Prazosin (Minipress), an alpha 1 blocker/adrenergic antagonist, what adverse effect would you want to warn your patient about?
A. syncope (fainting)
B. constipation
C. tachycardia
A. fainting (dilation causes drop in BP which leads to fainting; administer at bedtime to prevent)
SNS is ___ (rest/digest or flight or flight)
PNS is ___ (rest/digest or flight or flight)
SNS = fight or flight
PNS = rest/digest
Cholinergic agonists are going to activate cholinergic synapses and release which neurotransmitter into the synaptic cleft to produce the rest and digest response?
A. acetylcholine
B.norepinephrine
C. dopamine
D. serotonin
A. acetylcholine
Cholinergic antagonists have ALOT of side effects, and therefore want to be avoided if possible. What side effect would you expect to see with the CNS? (select all that apply)
A. lethargy
B. restlessness
C. fatigue
D. hallucinations
B. restlessness and D. hallucinations
You know that Alpha 1 receptors cause constriction. If you administer Sudafed, an alpha 1 receptor agonist, what would you expect the intended outcome of the medication be?
A. reduction of nasal secretions and ease of nasal breathing
B. increased nasal congestion and difficulty breathing
C. neither of the above
A. reduction of nasal secretions
why would you tell someone to avoid alcohol when taking a beta blocker?
leads to vasodilation, increasing hypotension and orthostatic hypotension
When the SNS is up-regulated, the patient will experience which of the following? (select all that apply)
A. dilated bronchi
B. decreased urine formation
C. more glucose production by liver
D. decreased peristalsis
ABCD
Knowing that cholinergic agonists mimic the PNS (rest and digest system), what would be a contraindication when giving this med? In other words, if a patient has which of the following conditions would you NOT want to administer the med?
A. bowel obstruction
B. Asthma
C. post-op bladder surgeryD. all the above
D. all the above
Which anticholinergic medication is used pre-operatively for control of secretions and motion sickness?
A. scopolamine
B. Detrol
C. Atropine
Beta1 receptor adrenergic agonists are critical care drugs that have powerful affects on the heart. What conditions would you expect this to be used in? (select all that apply)
A. Heart attack
B. Shock
C. Arrhythmia
D. Heart failure
E. Hypertension
D.
A, B, D
A. heart failure
B. COPD or asthma
C. coronary artery disease
B. COPD or asthma - beta 2 receptors are located on the lungs so a nonselective beta blocker would cause constriction to the lungs (selective blockers block only beta 1 receptors on the heart, so they are safe to give with patients that have asthma/COPD)
When your patient has been resting all day in bed and you come to assess their vitals, what results would you expect? (select all that apply)
A. increased bowel sounds
B. dilated pupils
C. decreased BP
D. increased urine formation
ACD - increased bowel sounds, decreased BP, increased urine formation
When monitoring a patient's status after administering bethanechol chloride, a cholinergic agonist, you would expect which of the following results:
A. tachycardia
B. hypotension
C. decreased bowel sounds
D. dilated pupils
B. hypotension
Atropine, the prototype drug for anticholinergics, is used in CPR to increase HR rapidly. It is an antidote for muscarinic agonist OD. Knowing the action of this drug, what nursing responsibility takes priority?
A. monitor I&O
B. assess CNS for changes
C. assess for photophobia
D. monitor vital signs (paradoxical bradycardia)
D. vital signs/paradoxical bradycardia
Beta 2 receptor adrenergic agonists are used in treatment of asthma as they cause dilation. What is the other indication for these medications?
A. hypotension
B. preterm labor
C. urinary frequency
B. preterm labor - relaxes uterus and stops contractions
After administering Metoprolol, a selective beta blocker, what assessment/effect would concern you the most?
A. HR <60
B. dizziness
C. heartburn
D. BP 110/76
A. HR <60