Nursing Interventions 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措施
Implementation with Rationale 实施与说明
Use extreme caution in calculating and preparing doses of these drugs because even small errors could have serious effects. Always dilute a parenteral drug before use if it is not prediluted to prevent tissue irritation on injection.
Use proper, aseptic technique when administering ophthalmic or nasal agents to prevent injection and assure the therapeutic effectiveness of the drug.
使用眼或鼻剂以避免注射时应使用正确的无菌技术，确保药物的治疗效果
Monitor patients receiving the drug ophthalmically or nasally for all of the systemic effects associated with parenteral administration to prevent potentially serious adverse effects if the drug is absorbed systemically.
Monitor patient response closely (blood pressure, ECG, urine output, cardiac output) and adjust dose accordingly to ensure the most benefit with the least amount of toxicity.
密切监测患者反应（血压、ECG、尿排量、心排血量），相应调整剂量，确保以最少毒性获取最大收益
Maintain phentolamine on standby in case extravasation occurs; infiltration of the site with 10 mL of saline containing 5 to 10 mg of phentolamine is usually effective in saving the area.
Offer support and encouragement to deal with the drug regimen.
提供支持与鼓励，应对药物治疗方案
Provide comfort measures to help the patient cope with sympathomimetic effects of the drug.
提供舒适措施，帮助患者应对药物的拟交感神经效应
Monitor light exposure to prevent sensitivity to light caused by pupil dilation, encourage voiding before giving the drug to alleviate urinary retention caused by sphincter contraction, monitor bowel function and provide assistance as needed to deal with GI suppression, and offer support and relaxation measures to deal with feelings of tension and anxiety.
Provide the following patient teaching to patients using these drugs orally or ophthalmically. Most of these drugs are given in emergency situations and teaching will be based on the patient’s condition and awareness. Teaching includes:
Drug name, prescribed dosage, and schedule for administration
药名、处方剂量、给药计划
Rationale for the drug 药物原理说明
Proper technique for administration 正确的给药技术
Measures to prevent or avoid adverse effects 防止或避免不良效应的措施
Need to check with prescriber before taking any OTC medication
服用OTC药物的向处方医师核实的必要性
Warning signs that might indicate a problem 可能提示问题的警示信号
Importance of avoiding intake of caffeine-containing products
避免摄入含咖啡因产品的重要性
Need for follow-up monitoring and evaluation 后续监测和评价的必要性
★Vocabulary ★
dilute – v. 稀释
prediluted – a. 稀释前的
aseptic – a. 无菌的，洁净的
assure – v. 使确信，向保证
phentolamine – n. 酚妥拉明
standby – n. 备用
extravasation – n. 外溢，溢出物
infiltration – n. 浸润，渗入
★Test ★ 1. A 40-year-old man is brought to the emergency department after suffering a cardiac arrest while in a shopping mall. His blood pressure is 70/40 mm Hg and his pulse is 40 beats/minute. He is given a dose of intravenous epinephrine. Which of the following reactions is necessary to induce a biologic response of increased heart rate?
A. Detrusor contraction
B. Drug-receptor complex formation
C. Hepatic oxidation reaction
D. Renal arteriolar contraction 2. A 59-year-old female with diabetes presents to her primary care physician for routine follow-up. Her current medications include insulin. Her fasting blood sugars are in the range of 80 to 120 mg/dL. The intracellular effects of this medication are likely caused by which of the following mechanisms of action?
A. Changes in ionic concentration within the cell
B. Changes in membrane potential
C. Protein phosphorylation
D. Protein and receptor phosphorylation
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案Answers 1. B. Drug-receptor complex formation. Rationale: The epinephrine must be recognized by a receptor to induce a biologic response. The drug will bind to the receptor. In this case, these are b-adrenergic receptors. A drug-receptor complex is formed. A biologic response is achieved. In this case, the biologic response is increased heart rate and blood pressure. 2. D. Protein and receptor phosphorylation. Rationale: This patient has diabetes and takes insulin. This medication (hormone) functions via insulin receptors. The transmembrane signaling mechanism for insulin involves protein and receptor phosphorylation.
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