Nursing Assessment for Patients Receiving Alpha- and Beta-Adrenergic Agonists
α-、β-肾上腺素能激动剂使用患者的护理评估
Assessment: History and Examination 评估：病史与体检
Assess for contraindications or cautions: Any known allergies to these drugs to avoid hypersensitivity reactions; pheochromocytoma, which could lead to fatal reactions due to systemic overload of catecholamines; tachyarrhythmias or ventricular fibrillation, which could be exacerbated by these drugs; hypovolemia, which would require fluid replacement as treatment for the associated hypotension; general anesthesia with halogenated hydrocarbon anesthetics, which could lead to serious cardiac effects; the presence of vascular disease, which could be exacerbated with the use of these drugs; and current status of pregnancy and lactation:
Perform a physical assessment to establish baseline status before beginning therapy, and during therapy, to evaluate for any potential adverse effects and to determine the effectiveness of therapy.
进行体格检查，建立治疗前和治疗期间基线状况，评价任何潜在的不良效应，确定治疗效果
Assess vital signs, especially pulse and blood pressure, to monitor for possible excess stimulation of the cardiac system; obtain an electrocardiogram (ECG) to evaluate for possible arrhythmias.
Note respiratory rate and auscultate lungs for adventitious sounds to evaluate effects on bronchi and respirations.
注意呼吸率，听诊肺音有无附加音，评价药物对支气管和呼吸的效应
Monitor urine output to evaluate perfusion of the kidneys and therapeutic effects.
监测尿拜师，评价肾灌注和治疗效应
Monitor the results of laboratory tests, such as renal and liver function tests, to determine the need for possible dose adjustment, and serum electrolyte levels to evaluate fluid loss and appropriateness of therapy.
1. You’re instructing a patient with asthma about the use of bronchodilators. You should teach the patient:
A. To take the medication 4 hours before exercise to prevent exercise-induced bronchospasm.
B. To take only the specific drugs prescribed for acute bronchospasm, usually a short-acting beta2-adrenergic agonist such as albuterol.
C. To double the dose of the medication in the event of a missed dose.
D. That long-acting beta2-adrenergic agonists, such as salmeterol, are effective in the treatment of acute asthma attacks.
2. A medical student is evaluating the effects of two a1-adrenergic agonist in a rat-based model. Agent A is a short-acting agent with a half-life of 4 h. Agent B is a long-acting agent with a half-life of 12 h. Which of the following effects would be most likely to be observed at 2 h after administration of both agents?
A. Decreased peripheral resistance
B. Hypotension
C. Miosis
D. Urethral sphincter closure
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答案Answers
1. B. Short-acting beta2-adrenergic agonists are used in the treatment of acute bronchospasm. Long-acting agents aren’t effective in acute attacks. To prevent exercise-induced asthma, medication should be taken 30 to 60 minutes before exercise. 2. D: Urethral sphincter closure.
a1-Adrenergic agonists have the following effects: closure of the urethral sphincter and increasing peripheral resistance. This will lead to an increase in blood pressure (hypertension). The ophthalmic effects of this agent include mydriasis.
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