Sympathetic vs. Parasympathetic
This division of the autonomic nervous system prepares the body for "fight or flight."
What is the sympathetic nervous system?
This receptor is primarily found in the heart and increases heart rate and contractility when stimulated.
What is the β₁ receptor?
This medication class stimulates the sympathetic nervous system by activating alpha and beta receptors.
What are adrenergic agonists?
This prototype adrenergic agonist is commonly used to treat anaphylaxis and cardiac arrest.
What is epinephrine?
Before administering metoprolol, this assessment should always be obtained.
What are the patient's heart rate and blood pressure?
This division slows the heart rate, increases digestion, and promotes "rest and digest."
What is the parasympathetic nervous system?
This receptor is primarily found in the lungs and causes bronchodilation when stimulated.
What is the β₂ receptor?
This medication class lowers heart rate and blood pressure by blocking beta receptors.
What are adrenergic antagonists (beta blockers)?
(Accept "beta blockers" or "adrenergic antagonists.")
This prototype beta-blocker selectively blocks β₁ receptors and is commonly prescribed for hypertension and heart failure.
What is metoprolol?
A patient taking metoprolol reports dizziness when standing. This nursing intervention should be included in patient teaching.
What is changing positions slowly to help prevent orthostatic hypotension and falls?
During a stressful situation, this physiologic response results from sympathetic stimulation.
What is an increased heart rate?
(Also acceptable: bronchodilation, pupil dilation, increased blood pressure.)
Stimulation of this receptor causes vasoconstriction, increasing blood pressure.
What is the α₁ receptor?
This medication class stimulates muscarinic receptors and promotes the "rest and digest" response.
What are cholinergic agonists?
This prototype cholinergic agonist stimulates muscarinic receptors to treat nonobstructive urinary retention.
What is bethanechol?
A patient asks, "Can I stop taking metoprolol once my blood pressure is normal?" This is the nurse's best response.
What is "No. Do not stop metoprolol without consulting your healthcare provider because abrupt discontinuation may lead to rebound hypertension or other cardiovascular complications."?
A patient is eating dinner after a long day. This autonomic division is primarily responsible for increasing gastrointestinal motility and secretions.
What is the parasympathetic nervous system?
A medication blocks β₁ receptors. The nurse should anticipate this physiologic response.
What are a decreased heart rate and decreased myocardial contractility?
(Accept "decreased heart rate" as the primary answer.)
This medication family blocks muscarinic receptors and is commonly used to increase heart rate or decrease secretions.
What are cholinergic antagonists (anticholinergics)?
(Accept "anticholinergics" or "cholinergic antagonists.")
This prototype anticholinergic medication blocks muscarinic receptors and is commonly used to treat symptomatic bradycardia.
What is atropine?
While preparing to administer a patient's first dose of metoprolol, the nurse obtains a heart rate of 52 beats/min. This is the nurse's priority action.
What is assessing the patient, reviewing the provider's hold parameters and institutional policy, and notifying the provider if indicated before administering the medication?
A patient arrives in the emergency department after a severe allergic reaction with hypotension, bronchoconstriction, and airway swelling. The nurse anticipates activation of this autonomic division when epinephrine is administered.
What is the sympathetic nervous system?
A patient with asthma accidentally receives a nonselective beta blocker. Blocking this receptor may worsen the patient's breathing.
What is the β₂ receptor?
A patient with symptomatic bradycardia requires immediate treatment. Based on the medication family, the nurse anticipates administering this type of medication.
What are cholinergic antagonists?
(Accept "anticholinergics" or specifically "atropine.")
A patient develops symptomatic bradycardia with a heart rate of 38 beats/min. Based on the medication's mechanism of action, the nurse anticipates administering this prototype medication to increase the heart rate.
What is atropine?
A nurse is caring for Mr. Thompson, who is starting metoprolol therapy. Place the steps of the nursing process in the correct order when preparing to administer the medication.
What is Assess → Diagnose → Plan → Implement → Evaluate (ADPIE)?
(Accept: Assess → Plan → Implement → Evaluate if students explain that nursing diagnoses are developed after assessment and before planning. This can spark a good discussion about the nursing process.)